0001209191-21-016969.txt : 20210303 0001209191-21-016969.hdr.sgml : 20210303 20210303170106 ACCESSION NUMBER: 0001209191-21-016969 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210301 FILED AS OF DATE: 20210303 DATE AS OF CHANGE: 20210303 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Czarnecki Christopher J CENTRAL INDEX KEY: 0001709616 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39529 FILM NUMBER: 21710119 MAIL ADDRESS: STREET 1: 800 CLINTON SQUARE CITY: ROCHESTER STATE: NY ZIP: 14604 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Broadstone Net Lease, Inc. CENTRAL INDEX KEY: 0001424182 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 CLINTON SQUARE CITY: Rochester STATE: NY ZIP: 14604 BUSINESS PHONE: 585-287-6500 MAIL ADDRESS: STREET 1: 800 CLINTON SQUARE CITY: Rochester STATE: NY ZIP: 14604 FORMER COMPANY: FORMER CONFORMED NAME: Broadstone Net Lease Inc DATE OF NAME CHANGE: 20080116 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-01 0 0001424182 Broadstone Net Lease, Inc. BNL 0001709616 Czarnecki Christopher J 800 CLINTON SQUARE ROCHESTER NY 14604 1 1 0 0 CEO & President Common Stock 2021-03-01 4 A 0 42988 0.00 A 262182 D Common Stock 54881 I By Trust Class A Common Stock 6000 D Reflects shares of restricted stock awarded to the Reporting Person on March 1, 2021, pursuant to the Broadstone Net Lease, Inc. 2020 Omnibus Equity and Incentive Plan. Such shares of restricted stock vest ratably on each of the first, second, third, and fourth anniversaries of February 28, 2021. This amount includes 111,280 shares of unvested restricted stock. The reported shares are owned jointly with the reporting person's spouse, with respect to which the reporting person shares voting and investment power. Shares held by a trust, of which the reporting person is a trustee and beneficiary. Each share of the Issuer's Class A Common Stock will automatically convert to one share of the Issuer's Common Stock on March 20, 2021, the date that is 180 days after the completion of the initial public offering of the Issuer's Class A Common Stock. John D. Moragne, as Attorney-in-Fact 2021-03-03