0001104659-23-111101.txt : 20231024
0001104659-23-111101.hdr.sgml : 20231024
20231024161522
ACCESSION NUMBER: 0001104659-23-111101
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231023
FILED AS OF DATE: 20231024
DATE AS OF CHANGE: 20231024
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Davis Mark Burton
CENTRAL INDEX KEY: 0001787766
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35629
FILM NUMBER: 231342862
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
tm2329081-1_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2023-10-23
0
0001552800
TILE SHOP HOLDINGS, INC.
TTSH
0001787766
Davis Mark Burton
C/O TILE SHOP HOLDINGS, INC
14000 CARLSON PARKWAY
PLYMOUTH
MN
55441
0
1
0
0
VP Inv. Relations & CAO
0
Common Stock
2023-10-23
4
F
0
4397
5.07
D
121210
D
Common Stock
820
I
By Child #1
Common Stock
775
I
By Child #2
Common Stock
765
I
By Child #3
Stock Option (Right to Buy)
8.5
2027-11-06
Common Stock
5400
5400
D
The reporting person has elected to satisfy his tax withholding obligation in connection with the vesting of a prior restricted stock grant by directing the Issuer to withhold shares otherwise issuable upon vesting of the previously reported grant.
Includes (i) 3,561 shares of restricted stock for which the risks of forfeiture will lapse on 3/16/24; (ii) 2,540 shares of restricted stock for which the risks of forfeiture will lapse on 3/15/24; (iii) 5,137 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/7/24 and 3/7/25; (iv) 9,260 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/6/24, 3/6/25 and 3/6/26; and
(v) the following shares of performance-based restricted stock, which are, in each case, subject to Mr. Davis remaining in continuous employment with the Issuer through 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 for which the risks of forfeiture will lapse on the date the Issuer files its annual report for the 2023 fiscal year; (B) 10,788 shares 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 the Issuer files its annual report for the 2023 and 2024 fiscal years, respectively; and (C) 18,519 shares for which the risks of forfeiture will lapse as to 30%, 30% and 40% on each of the dates the Issuer files its annual report for the 2023, 2024 and 2025 fiscal years, respectively. The Issuer's proxy statement contains additional information regarding the applicable performance targets.
Fully exercisable.
/s/ Mark B. Davis
2023-10-24