0000741815-17-000068.txt : 20170906 0000741815-17-000068.hdr.sgml : 20170906 20170906171041 ACCESSION NUMBER: 0000741815-17-000068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170810 FILED AS OF DATE: 20170906 DATE AS OF CHANGE: 20170906 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dubois Henry Edward CENTRAL INDEX KEY: 0001349983 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09972 FILM NUMBER: 171072046 MAIL ADDRESS: STREET 1: 21700 ATLANTIC BOULEVARD CITY: DULLES STATE: VA ZIP: 20602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HOOPER HOLMES INC CENTRAL INDEX KEY: 0000741815 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 221659359 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 560 N. ROGERS ROAD CITY: OLATHE STATE: KS ZIP: 66062 BUSINESS PHONE: 9137641045 MAIL ADDRESS: STREET 1: 560 N. ROGERS ROAD CITY: OLATHE STATE: KS ZIP: 66062 4 1 wf-form4_150473222754222.xml FORM 4 X0306 4 2017-08-10 0 0000741815 HOOPER HOLMES INC HPHW 0001349983 Dubois Henry Edward 560 N. ROGERS ROAD OLATHE KS 66062 1 1 0 0 CEO Stock Options (Right to Buy) 0.65 2017-08-10 4 A 0 250000 0 A 2027-05-11 Common Stock 250000.0 250000 D Stock Options (Right to Buy) 0.65 2017-08-10 4 A 0 250000 0 A 2027-05-11 Common Stock 250000.0 250000 D As previously reported in the Company's proxy statement filed on June 29, 2017, the Company awarded these options to the reporting person at closing of the Company's merger with Provant Health Solutions, LLC on May 11, 2017, subject to approval by the Company's shareholders of an amendment to the plan under which the options were granted. The Company's shareholders approved the plan amendment at the Company's annual meeting held on August 10, 2017. Shares subject to this Option vest in 25% tranches on each of the first, second, third and fourth anniversaries of the grant date of May 11, 2017. Shares subject to this Option vest and become exercisable only if the Company achieves certain run rate synergies for the calendar year ending December 31, 2017. /s/ Henry Dubois 2017-09-05