0000899243-22-035129.txt : 20221104 0000899243-22-035129.hdr.sgml : 20221104 20221104121448 ACCESSION NUMBER: 0000899243-22-035129 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221103 FILED AS OF DATE: 20221104 DATE AS OF CHANGE: 20221104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Miller David CENTRAL INDEX KEY: 0001577126 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39172 FILM NUMBER: 221361170 MAIL ADDRESS: STREET 1: 53 FOREST AVENUE CITY: OLD GREENWICH STATE: CT ZIP: 06870 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Stonemor Inc. CENTRAL INDEX KEY: 0001753886 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3600 HORIZON BOULEVARD CITY: TREVOSE STATE: PA ZIP: 19053 BUSINESS PHONE: (215) 826-2800 MAIL ADDRESS: STREET 1: 3600 HORIZON BOULEVARD CITY: TREVOSE STATE: PA ZIP: 19053 FORMER COMPANY: FORMER CONFORMED NAME: Stonemor GP LLC DATE OF NAME CHANGE: 20180921 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-11-03 0 0001753886 Stonemor Inc. STON 0001577126 Miller David C/O STONEMOR INC. 3331 STREET ROAD, SUITE 200 BENSALEM PA 19020 1 0 0 0 Common Stock 2022-11-03 4 D 0 941432 3.50 D 0 D Restricted Phantom Common Stock 2022-11-03 4 D 0 57466.239 3.50 D Common Stock 57466.239 0 D This award of restricted phantom common stock was cancelled in the merger contemplated by an Agreement and Plan of Merger among Axar Cemetery Parent Corp., StoneMor Inc. and Axar Cemetery Merger Corp. in exchange for a cash payment of $201,131.84, representing the cash merger consideration per share. The filing of this statement shall not be construed as an admission (a) that the person filing this statement is, for the purposes of Section 16 of the Securities Exchange Act of 1934, as amended, the beneficial owners of any equity securities covered by this statement, or (b) that this statement is legally required to be filed by such person. /s/ Shirley Herman, Attorney-in-Fact 2022-11-04