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