0001567619-20-021569.txt : 20201223 0001567619-20-021569.hdr.sgml : 20201223 20201223182032 ACCESSION NUMBER: 0001567619-20-021569 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201221 FILED AS OF DATE: 20201223 DATE AS OF CHANGE: 20201223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nakazawa Michele CENTRAL INDEX KEY: 0001356840 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-08443 FILM NUMBER: 201413881 MAIL ADDRESS: STREET 1: C/O TELOS CORPORATION STREET 2: 19886 ASHBURN ROAD CITY: ASHBURN STATE: VA ZIP: 20147 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TELOS CORP CENTRAL INDEX KEY: 0000320121 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 520880974 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 19886 ASHBURN ROAD CITY: ASHBURN STATE: VA ZIP: 20147 BUSINESS PHONE: 7034716000 MAIL ADDRESS: STREET 1: 19886 ASHBURN ROAD CITY: ASHBURN STATE: VA ZIP: 20147 FORMER COMPANY: FORMER CONFORMED NAME: C3 INC DATE OF NAME CHANGE: 19920703 4 1 doc1.xml FORM 4 X0306 4 2020-12-21 0 0000320121 TELOS CORP TLS 0001356840 Nakazawa Michele C/O TELOS CORPORATION 19 ASHBURN VA 20147 0 1 0 0 EVP, CFO Common Stock 2020-12-21 4 G 0 840000 0 D 501198 D Common Stock 2020-12-21 5 G 0 420000 0 A 420000 I Held by Spouse Common Stock 2020-12-21 4 G 0 420000 0 A 420000 I By LLC Common Stock 2020-12-21 4 G 0 420000 0 D 0 I Held by Spouse Common Stock 2020-12-21 4 G 0 420000 0 A 840000 I By LLC Common Stock 126104.50 I By 401(k) plan Reflects approximately 0.794 to 1 reverse stock split effective November 12, 2020. This transaction involved a gift of securities by the reporting person to her spouse. The reporting person disclaims beneficial ownership of the shares held by her spouse, and this report should not be deemed an admission that the reporting person is the beneficial owner of her spouse's shares for purposes of Section 16 or for any other purpose. The shares are held by the Nakazawa Family Investment, LLC, a limited liability company of which the reporting person and her spouse are the managers and the only members. The reporting person disclaims beneficial ownership of the securities and the filing of the report is not an admission that the reporting person is the beneficial owner of the securities for the purpose of Section 16 or otherwise. /s/ Helen M. Oh, attorney-in-fact 2020-12-23