0001104659-22-071714.txt : 20220616 0001104659-22-071714.hdr.sgml : 20220616 20220616095834 ACCESSION NUMBER: 0001104659-22-071714 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211203 FILED AS OF DATE: 20220616 DATE AS OF CHANGE: 20220616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Glasser Deborah K CENTRAL INDEX KEY: 0001812126 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 221019578 MAIL ADDRESS: STREET 1: C/O TILE SHOP HOLDINGS, 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 tm2218509-2_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-12-03 0 0001552800 TILE SHOP HOLDINGS, INC. TTSH 0001812126 Glasser Deborah K C/O TILE SHOP HOLDINGS, INC 14000 CARLSON PARKWAY PLYMOUTH MN 55441 1 0 0 0 Common Stock 2021-12-03 4 P 0 266 7.63 A 3384 I By Spouse Common Stock 2022-06-14 4 A 0 24943 0 A 123269 D Includes 9,037 shares held in account jointly with spouse. Represents shares of restricted stock granted pursuant to the Company's 2021 Omnibus Equity Compensation Plan, which are subject to a risk of forfeiture until the earlier of (a) the date of the Company's next annual meeting of stockholders and (b) June 14, 2023. /s/ Mark Davis as Attorney-in-Fact for Deborah K. Glasser pursuant to Power of Attorney 2022-06-16