0000914190-17-000192.txt : 20170724
0000914190-17-000192.hdr.sgml : 20170724
20170724162628
ACCESSION NUMBER: 0000914190-17-000192
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170720
FILED AS OF DATE: 20170724
DATE AS OF CHANGE: 20170724
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: JACULLO PETER J III
CENTRAL INDEX KEY: 0001555194
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35629
FILM NUMBER: 17978538
MAIL ADDRESS:
STREET 1: C/O THE TILE SHOP, INC.
STREET 2: 14000 CARLSON PARKWAY
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TILE SHOP HOLDINGS, INC.
CENTRAL INDEX KEY: 0001552800
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-HOME FURNITURE, FURNISHINGS & EQUIPMENT STORES [5700]
IRS NUMBER: 455538095
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 14000 CARLSON PARKWAY
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
BUSINESS PHONE: 763-852-2950
MAIL ADDRESS:
STREET 1: 14000 CARLSON PARKWAY
CITY: PLYMOUTH
STATE: MN
ZIP: 55441
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2017-07-20
0001552800
TILE SHOP HOLDINGS, INC.
TTS
0001555194
JACULLO PETER J III
C/O TILE SHOP HOLDINGS, INC.
14000 CARLSON PARKWAY
PLYMOUTH
MN
55441
1
0
0
0
Common Stock
2017-07-20
4
P
0
10000
14.35
A
286754
D
Common Stock
2017-07-20
4
P
0
2677
14.05
A
289431
D
Common Stock
2017-07-21
4
P
0
1395
13.90
A
290826
D
Common Stock
4441180
I
By JWTS, Inc.
Includes 5,038 shares of restricted stock granted pursuant to the Company's 2012 Omnibus Award Plan, which are subject to a purchase option in favor of the Company until the earlier of (a) the date of the Company's next annual meeting of stockholders and (b) July 13, 2018.
These securities are owned by JWTS, Inc. The reporting person is the sole director of JWTS, Inc. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or any other purpose.
/s/ John R. Houston as Attorney-in-Fact for Peter J. Jacullo III pursuant to Power of Attorney previously filed.
2017-07-24