0000741815-17-000069.txt : 20170906
0000741815-17-000069.hdr.sgml : 20170906
20170906171056
ACCESSION NUMBER: 0000741815-17-000069
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: Balthazor Steven R
CENTRAL INDEX KEY: 0001652032
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-09972
FILM NUMBER: 171072047
MAIL ADDRESS:
STREET 1: 506 N. ROGERS ROAD
CITY: OLATHE
STATE: KS
ZIP: 66062
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_150473224281368.xml
FORM 4
X0306
4
2017-08-10
0
0000741815
HOOPER HOLMES INC
HPHW
0001652032
Balthazor Steven R
560 N. ROGERS RD.
OLATHE
KS
66062
0
1
0
0
Chief Financial Officer
Stock Options (Right to Buy)
0.65
2017-08-10
4
A
0
125000
0
A
2027-05-11
Common Stock
125000.0
125000
D
Stock Options (Right to Buy)
0.65
2017-08-10
4
A
0
125000
0
A
2027-05-11
Common Stock
125000.0
125000
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 grand 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/ Steven R. Balthazor
2017-09-06