0001567619-19-014437.txt : 20190703 0001567619-19-014437.hdr.sgml : 20190703 20190703184209 ACCESSION NUMBER: 0001567619-19-014437 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190701 FILED AS OF DATE: 20190703 DATE AS OF CHANGE: 20190703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nia Mehran CENTRAL INDEX KEY: 0001386428 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33264 FILM NUMBER: 19942907 MAIL ADDRESS: STREET 1: 17150 SOUTH MARGAY AVENUE CITY: CARSON STATE: CA ZIP: 90746 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: U.S. Auto Parts Network, Inc. CENTRAL INDEX KEY: 0001378950 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO & HOME SUPPLY STORES [5531] IRS NUMBER: 680623433 STATE OF INCORPORATION: DE FISCAL YEAR END: 1228 BUSINESS ADDRESS: STREET 1: 16941 KEEGAN AVE CITY: CARSON STATE: CA ZIP: 90746 BUSINESS PHONE: (310) 735-0085 MAIL ADDRESS: STREET 1: 16941 KEEGAN AVE CITY: CARSON STATE: CA ZIP: 90746 4 1 doc1.xml FORM 4 X0306 4 2019-07-01 0 0001378950 U.S. Auto Parts Network, Inc. PRTS 0001386428 Nia Mehran C/O US AUTO PARTS NETWORK, INC. 16941 KEEGAN AVENUE CARSON CA 90746 0 0 1 0 Common Stock 2019-07-01 4 A 0 12241 0 A 4736084 I Nia Living Trust Established September 2, 2004 Common Stock 199437 I By domestic partner Represents shares issued as dividends for preferred shares. The amount consists of 3,615,391 shares of Common Stock owned directly by the Nia Living Trust Established September 2, 2004 (the "Living Trust"), of which Mehran Nia and Fariba Nia, are co-trustees, (ii) 1,034,482 shares of Common Stock issuable upon conversion of Series A Convertible Preferred Stock owned by the Living Trust, and (iii) 86,211 shares of Common Stock issued in lieu of preferred stock dividends Mehran Nia 2019-07-03