0001181431-12-029239.txt : 20120510
0001181431-12-029239.hdr.sgml : 20120510
20120510195420
ACCESSION NUMBER: 0001181431-12-029239
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120509
FILED AS OF DATE: 20120510
DATE AS OF CHANGE: 20120510
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TILLY'S, INC.
CENTRAL INDEX KEY: 0001524025
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-APPAREL & ACCESSORY STORES [5600]
IRS NUMBER: 452164791
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0131
BUSINESS ADDRESS:
STREET 1: 10 WHATNEY
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: (949) 609-5599
MAIL ADDRESS:
STREET 1: 10 WHATNEY
CITY: IRVINE
STATE: CA
ZIP: 92618
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HS ANNUITY TRUST
CENTRAL INDEX KEY: 0001548785
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35535
FILM NUMBER: 12831911
BUSINESS ADDRESS:
STREET 1: C/O TILLY'S, INC.
STREET 2: 10 WHATNEY
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: (949) 609-5599
MAIL ADDRESS:
STREET 1: C/O TILLY'S, INC.
STREET 2: 10 WHATNEY
CITY: IRVINE
STATE: CA
ZIP: 92618
4
1
rrd344661.xml
HSANNUITY F4
X0305
4
2012-05-09
1
0001524025
TILLY'S, INC.
TLYS
0001548785
HS ANNUITY TRUST
C/O TILLY'S, INC.
10 WHATNEY
IRVINE
CA
92618
0
0
1
0
CLASS A COMMON STOCK
2012-05-09
4
C
0
160000
0
A
160000
D
CLASS A COMMON STOCK
2012-05-09
4
S
0
160000
14.415
D
0
D
CLASS B COMMON STOCK
2012-05-09
4
C
0
160000
0
D
CLASS A COMMON STOCK
160000
1840000
D
Class B Common Stock has no expiration date and, subject to certain events, is automatically convertible on a one-for-one basis into shares of Class A Common Stock.
The shares of Class B Common Stock reported on this line item converted into the Issuer's Class A Common Stock on a one-for-one basis upon the closing of the Issuer's initial public offering and sale to the underwriters.
Represents the public offering price of $15.50 per share of Class A Common Stock less the underwriter's discount of $1.085 per share of Class A Common Stock.
/s/ PATRICK GROSSO, ATTORNEY-IN-FACT FOR NETTA SCHROER AND AMY SHAKED, CO-TRUSTEES OF THE HS ANNUITY TRUST
2012-05-10