0001104659-24-061938.txt : 20240515
0001104659-24-061938.hdr.sgml : 20240515
20240515161520
ACCESSION NUMBER: 0001104659-24-061938
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240513
FILED AS OF DATE: 20240515
DATE AS OF CHANGE: 20240515
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Davis Mark Burton
CENTRAL INDEX KEY: 0001787766
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35629
FILM NUMBER: 24950914
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]
ORGANIZATION NAME: 07 Trade & Services
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
tm2414576-1_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2024-05-13
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
Senior VP, CFO and Secretary
0
Common Stock
2024-05-13
4
A
0
2464
0
A
116774
D
Common Stock
2024-05-13
4
A
0
4928
0
A
121702
D
Stock Option (Right to Buy)
8.5
2027-11-06
Common Stock
5400
5400
D
Represents shares of restricted stock for which the risks of forfeiture will lapse in three equal annual installments on each of 5/13/25, 5/13/26 and 5/13/27, subject to continuous employment as of the applicable vesting date.
Represents shares of performance-based restricted stock for which the risks of forfeiture will lapse as to 30% of the shares on May 13, 2025, 30% of the shares on the date the Issuer files its annual report for the year ending December 31, 2025, and 40% of the shares on the date the Issuer files its annual report for the year ending December 31, 2026, subject to (i) Mr. Davis remaining in continuous employment with the Issuer through December 31 of the year preceding the applicable vesting date and (ii) the Issuer achieving 12%, 14% and 15% of adjusted pre-tax return on capital employed for each respective year.
Includes (i) 2,568 shares of restricted stock for which the risks of forfeiture will lapse on 3/7/25; (ii) 6,173 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/6/25 and 3/6/26; (iii) 7,562 shares for which the risks of forfeiture will lapse in equal annual installments on each of 3/4/25, 3/4/26 and 3/4/27; (iv) 2,464 shares for which the risks of forfeiture will lapse in equal annual installments on each of 5/13/25, 5/13/26 and 5/13/27; 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:
(cont.) (A) 6,165 shares for which the risks of forfeiture will lapse on the date the Issuer files its annual report for the 2024 fiscal year; (B) 12,963 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 2024 and 2025 fiscal years, respectively; (C) 15,125 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 2024, 2025 and 2026 fiscal years, respectively; and (D) 4,928 shares for which the risks of forfeiture will lapse as to 30%, 30% and 40% on each of May 13, 2025 and the dates the Issuer files its annual report for the 2025 and 2026 fiscal years, respectively. The Issuer's proxy statement contains additional information regarding the applicable performance targets.
Fully exercisable.
/s/ Mark B. Davis
2024-05-15