0001628280-24-004130.txt : 20240209
0001628280-24-004130.hdr.sgml : 20240209
20240209173607
ACCESSION NUMBER: 0001628280-24-004130
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231231
FILED AS OF DATE: 20240209
DATE AS OF CHANGE: 20240209
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ellis Mathew Scot
CENTRAL INDEX KEY: 0001929049
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38136
FILM NUMBER: 24616372
MAIL ADDRESS:
STREET 1: C/O ACCEL ENTERTAINMENT, INC.
STREET 2: 140 TOWER DR.
CITY: BURR RIDGE
STATE: IL
ZIP: 60527
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Accel Entertainment, Inc.
CENTRAL INDEX KEY: 0001698991
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-AMUSEMENT & RECREATION SERVICES [7900]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 981350261
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 140 TOWER DRIVE
CITY: BURR RIDGE
STATE: IL
ZIP: 60527
BUSINESS PHONE: 630-972-2235
MAIL ADDRESS:
STREET 1: 140 TOWER DRIVE
CITY: BURR RIDGE
STATE: IL
ZIP: 60527
FORMER COMPANY:
FORMER CONFORMED NAME: TPG Pace Holdings Corp.
DATE OF NAME CHANGE: 20170224
5
1
wk-form5_1707518157.xml
FORM 5
X0508
5
2023-12-31
0
1
0
0001698991
Accel Entertainment, Inc.
ACEL
0001929049
Ellis Mathew Scot
C/O ACCEL ENTERTAINMENT, INC.
140 TOWER DRIVE
BURR RIDGE
IL
60527
0
1
0
0
Chief Financial Officer
0
Class A-2 Common Stock
3
Class A-1 Common Stock
0
518
D
The Reporting Person owned 518 shares of the Issuer's Class A-2 Common Stock on May 1, 2022, the date on with the Reporting Person became an executive officer of the Company. The Issuer's Class A-2 Common Stock will automatically convert into an equal number of the Issuer's Class A-1 Common Stock in three separate tranches, with no action required of the holder thereof, upon the satisfaction of certain predetermined stock price or earnings thresholds as set forth in the Restricted Stock Agreement dated as of November 20, 2019, by and among the Issuer, the Reporting Person and the other persons party thereto. The first stock price threshold was achieved on January 14, 2020. The Class A-2 Common Stock has no expiration date.
/s/ Derek Harmer, Attorney-in-fact for Mathew Ellis
2024-02-09