0001209191-17-051268.txt : 20170905
0001209191-17-051268.hdr.sgml : 20170904
20170905161257
ACCESSION NUMBER: 0001209191-17-051268
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170901
FILED AS OF DATE: 20170905
DATE AS OF CHANGE: 20170905
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Clarke Ben
CENTRAL INDEX KEY: 0001714020
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37530
FILM NUMBER: 171068880
MAIL ADDRESS:
STREET 1: 500 WEST 5TH STREET
CITY: AUSTIN
STATE: TX
ZIP: 78701
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Amplify Snack Brands, INC
CENTRAL INDEX KEY: 0001640313
STANDARD INDUSTRIAL CLASSIFICATION: FOOD & KINDRED PRODUCTS [2000]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 500 WEST 5TH STREET
CITY: AUSTIN
STATE: TX
ZIP: 78701
BUSINESS PHONE: 847-982-9800
MAIL ADDRESS:
STREET 1: 500 WEST 5TH STREET
CITY: AUSTIN
STATE: TX
ZIP: 78701
FORMER COMPANY:
FORMER CONFORMED NAME: TA Holdings 1, Inc.
DATE OF NAME CHANGE: 20150422
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-09-01
0
0001640313
Amplify Snack Brands, INC
BETR
0001714020
Clarke Ben
500 WEST 5TH STREET
AUSTIN
TX
78701
1
0
0
0
Common Stock
2017-09-01
4
A
0
27972
0.00
A
27972
D
These shares represent Restricted Stock Units (each, an "RSU") and will be settled in the Issuer's Common Stock upon vesting. Each RSU represents a contingent right to receive one share of the Issuer's Common Stock. The RSUs will vest according to the following schedule: 1/3rd of the RSUs will vest on September 1, 2018, 1/3rd of the RSUs will vest on September 1, 2019, and 1/3rd of the RSUs will vest on September 1, 2020, provided that the Reporting Person continues to have a service relationship with the Issuer through each such date.
/s/ Bradley C. Weber, as Attorney-in-Fact to the Reporting Person
2017-09-01