0001104659-22-030459.txt : 20220304 0001104659-22-030459.hdr.sgml : 20220304 20220304121346 ACCESSION NUMBER: 0001104659-22-030459 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220303 FILED AS OF DATE: 20220304 DATE AS OF CHANGE: 20220304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lolmaugh Cabell CENTRAL INDEX KEY: 0001731797 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 22713047 MAIL ADDRESS: STREET 1: C/O 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 tm228436-1_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2022-03-03 0 0001552800 TILE SHOP HOLDINGS, INC. TTSH 0001731797 Lolmaugh Cabell C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH MN 55441 1 1 0 0 Chief Executive Officer Common Stock 2022-03-03 4 D 0 9129 0 D 164789 D Stock Option (Right to Buy) 10 2022-08-21 Common Stock 2750 2750 D Stock Option (Right to Buy) 14.19 2022-07-14 Common Stock 1613 1613 D Stock Option (Right to Buy) 8.5 2027-11-06 Common Stock 26900 26900 D Stock Option (Right to Buy) 5.55 2028-02-22 Common Stock 56000 56000 D Stock Option (Right to Buy) 6.26 2029-02-20 Common Stock 97067 97067 D Represents forfeiture of unvested performance-based restricted stock as a result of the applicable performance target not being achieved. Includes (i) 85,482 shares of restricted stock for which the risks of forfeiture will lapse as to 28,494 shares on each of 3/16/22, 3/16/23 and 3/16/24; (ii) 15,214 shares of restricted stock for which the risks of forfeiture will lapse as to 5,071 shares on each of 3/15/22 and 3/15/23 and 5,072 shares on 3/15/24; and (iii) 21,299 shares of performance-based restricted stock for which the risks of forfeiture will lapse in three installments of 9,128 and 12,171 on each of the dates that the Issuer files its annual report for the years ending December 31, 2022 and 2023, respectively, subject to Mr. Lolmaugh remaining in continuous employment with the Issuer prior to and as of December 31 of the year preceding the applicable vesting date and the Issuer achieving its performance target for each respective year. Fully exercisable. Options to purchase 24,267 shares vest on 2/20/23. /s/ Cabell Lolmaugh 2022-03-04