0001104659-23-029138.txt : 20230306 0001104659-23-029138.hdr.sgml : 20230306 20230306182341 ACCESSION NUMBER: 0001104659-23-029138 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230302 FILED AS OF DATE: 20230306 DATE AS OF CHANGE: 20230306 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KINDER JOSEPH CENTRAL INDEX KEY: 0001555217 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35629 FILM NUMBER: 23710355 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 tm238679-2_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2023-03-02 0 0001552800 TILE SHOP HOLDINGS, INC. TTSH 0001555217 KINDER JOSEPH C/O TILE SHOP HOLDINGS, INC. 14000 CARLSON PARKWAY PLYMOUTH MN 55441 0 1 0 0 See Remarks Common Stock 2023-03-02 4 D 0 9187 0 D 79721 D Common Stock 600 I By Spouse Stock Option (Right to Buy) 8.5 2027-11-06 Common Stock 26900 26900 D Stock Option (Right to Buy) 8.8 2028-07-20 Common Stock 50000 50000 D Represents forfeiture of unvested performance-based restricted stock granted in 2021 and 2022 as a result of the applicable performance targets not being achieved. Includes (i) 28,494 shares of restricted stock for which the risks of forfeiture will lapse as to 14,247 shares on each of 3/16/23 and 3/16/24; (ii) 5,073 shares of restricted stock for which the risks of forfeiture will lapse as to 2,533 shares on 3/15/23 and 2,540 shares on 3/15/24; (iii) 7,706 shares of restricted stock for which the risks of forfeiture will lapse in three equal annual installments on each of 3/7/23, 3/7/24 and 3/7/25; and (iv) the following shares of performance-based restricted stock, which are, in each case, subject to Mr. Kinder 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: (A) 6,085 shares of performance-based restricted stock for which the risks of forfeiture will lapse on the date that the Issuer files its annual report for the year ending December 31, 2023 and (B) 10,788 shares of performance-based restricted stock for which the risks of forfeiture will lapse as to 30% and 40% of the initial number of shares granted on each of the dates that the Issuer files its annual report for the years ending December 31, 2023 and 2024, respectively. The Issuer's proxy statement contains additional information regarding the applicable performance targets. Fully exercisable. SVP, Supply Chain & Distribution /s/ Joseph Kinder 2023-03-06