SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Adinolfi Jon

(Last) (First) (Middle)
10590 HAMILTON AVENUE

(Street)
CINCINNATI OH 45231

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/14/2021
3. Issuer Name and Ticker or Trading Symbol
Hillman Solutions Corp. [ HLMN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Div President, Hillman US
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 353,220(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options (2) 07/30/2030 Common Stock 218,393 $7.89 D
Stock Options (2) 07/15/2029 Common Stock 197,790 $8.5 D
Stock Options (3) 01/22/2031 Common Stock 219,712 $10 D
Explanation of Responses:
1. Includes 176,610 shares of restricted stock.
2. All shares underlying the option vest in four equal annual installments beginning on the first anniversary of the date of grant (which is 10 years prior to the expiration date), subject to the Reporting Person's continued employment with the Issuer through the applicable vesting date.
3. Two-thirds of the shares underlying the option vest in four equal annual installments beginning on the first anniversary of the date of grant (which is 10 years prior to the expiration date), subject to the Reporting Person's continued employment with the Issuer through the applicable vesting date. One-third of the shares underlying the option vest based on the achievement of performance criteria.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
By: /s/ Douglas D. Roberts, as attorney-in-fact 07/14/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.