0001179110-13-016856.txt : 20131121 0001179110-13-016856.hdr.sgml : 20131121 20131121173926 ACCESSION NUMBER: 0001179110-13-016856 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20131119 FILED AS OF DATE: 20131121 DATE AS OF CHANGE: 20131121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Levy Acquisition Corp CENTRAL INDEX KEY: 0001585583 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 BUSINESS ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 BUSINESS PHONE: 312-267-4190 MAIL ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Levy Family Partners, LLC CENTRAL INDEX KEY: 0001591723 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36197 FILM NUMBER: 131236205 BUSINESS ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 BUSINESS PHONE: 312-267-4190 MAIL ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Levy Acquisition Sponsor, LLC CENTRAL INDEX KEY: 0001586898 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36197 FILM NUMBER: 131236206 BUSINESS ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 BUSINESS PHONE: 312-267-4190 MAIL ADDRESS: STREET 1: 444 NORTH MICHIGAN AVENUE STREET 2: SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60611 4 1 edgar.xml FORM 4 - X0306 4 2013-11-19 0 0001585583 Levy Acquisition Corp LEVY 0001586898 Levy Acquisition Sponsor, LLC 444 NORTH MICHIGAN AVENUE SUITE 3500 CHICAGO IL 60611 0 0 1 0 0001591723 Levy Family Partners, LLC 444 NORTH MICHIGAN AVENUE SUITE 3500 CHICAGO IL 60611 0 0 1 0 Common Stock 2013-11-19 4 J 0 553500 0 D 3690000 D Private Placement Warrants 11.50 2013-11-19 4 P 0 4750000 1.00 A Common Stock 4750000 4750000 D Private Placement Warrants 11.50 2013-11-19 4 G 0 60000 0 D Common Stock 60000 4690000 D Forfeiture to the Issuer for no consideration because the underwriter for the Issuer's initial public offering did not exercise the over-allotment option. Includes 922,500 shares which may be forfeited on the 5th anniversary of the Issuer's initial business combination, unless following the initial business combination the last sale price of the Issuer's common stock equals or exceeds $13.00 per share (as adjusted for stock splits, stock dividends, reorganizations, recapitalizations or the like) for any 20 trading days within any 30-trading day period or the Issuer completes a liquidation, merger, stock exchange or similar transaction that results in all of its stockholders having the right to exchange their shares of common stock for consideration in cash, securities or other property which equals or exceeds $13.00 per share (as adjusted for stock splits, stock dividends, reorganizations, recapitalizations or the like). The securities are held directly by Levy Acquisition Sponsor, LLC and indirectly by Levy Family Partners, LLC which is the managing member of Levy Acquisition Sponsor, LLC. The warrants will become exercisable beginning on the later of one year after issuance or 30 days after the completion of the Issuer's initial business combination. The warrants expire five years after the completion of the Issuer's initial business combination or earlier upon redemption or liquidation. /s/ Zachary Swartz, Attorney-in-Fact 2013-11-21 /s/ Zachary Swartz, Attorney-in-Fact 2013-11-21