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