0001209191-16-155135.txt : 20161214 0001209191-16-155135.hdr.sgml : 20161214 20161214160154 ACCESSION NUMBER: 0001209191-16-155135 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161212 FILED AS OF DATE: 20161214 DATE AS OF CHANGE: 20161214 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TOWN SPORTS INTERNATIONAL HOLDINGS INC CENTRAL INDEX KEY: 0001281774 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEMBERSHIP SPORTS & RECREATION CLUBS [7997] IRS NUMBER: 200640002 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5 PENN PLAZA STREET 2: 4TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10001 BUSINESS PHONE: (212) 246-6700 MAIL ADDRESS: STREET 1: 5 PENN PLAZA STREET 2: 4TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ajmera Nitin CENTRAL INDEX KEY: 0001607717 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36803 FILM NUMBER: 162051143 MAIL ADDRESS: STREET 1: 5 PENN PLAZA CITY: NEW YORK STATE: NY ZIP: 10001 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-12-12 0 0001281774 TOWN SPORTS INTERNATIONAL HOLDINGS INC CLUB 0001607717 Ajmera Nitin 5 PENN PLAZA NEW YORK NY 10001 0 1 0 0 SVP - Controller Common Stock, par value $0.001 2016-12-12 4 A 0 15000 0.00 A 54161 D These shares of restricted stock vest in three equal annual installments commencing on December 12, 2017, the first anniversary of the grant date. /s/ Kieran Sikso, Attorney-in-Fact 2016-12-14