0001615774-17-007594.txt : 20171226 0001615774-17-007594.hdr.sgml : 20171226 20171226173104 ACCESSION NUMBER: 0001615774-17-007594 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171221 FILED AS OF DATE: 20171226 DATE AS OF CHANGE: 20171226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WEIL A LORNE CENTRAL INDEX KEY: 0000921873 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36689 FILM NUMBER: 171274970 MAIL ADDRESS: STREET 1: C/O HYDRA INDUSTRIES ACQUISITION CORP STREET 2: 250 WEST 57TH STREET, SUITE #2223 CITY: NEW YORK STATE: NY ZIP: 10107 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Inspired Entertainment, Inc. CENTRAL INDEX KEY: 0001615063 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 471025534 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 250 WEST 57TH STREET, 22ND FLOOR CITY: NEW YORK STATE: NY ZIP: 10107 BUSINESS PHONE: (646) 565-3861 MAIL ADDRESS: STREET 1: 250 WEST 57TH STREET, 22ND FLOOR CITY: NEW YORK STATE: NY ZIP: 10107 FORMER COMPANY: FORMER CONFORMED NAME: Hydra Industries Acquisition Corp. DATE OF NAME CHANGE: 20140728 4 1 s108541_4.xml 4 X0306 4 2017-12-21 0 0001615063 Inspired Entertainment, Inc. INSE 0000921873 WEIL A LORNE 250 WEST 57TH STREET NEW YORK NY 10107 1 1 1 0 Executive Chairman Common Stock 2017-12-21 4 D 0 926272 0 D 0 D Common Stock 476308 I See Footnote Restricted Stock Units 2017-12-21 5 A 0 E 926272 0.00 A Common Stock 926272 926272 D A. Lorne Weil and Inspired Entertainment, Inc. (the "Company") agreed to the forfeiture and cancellation of such shares of common stock, which had previously been granted by the Company to Mr. Weil in the form of restricted stock under the Company's 2016 Long-Term Incentive Plan. Represents 476,308 shares of common stock held by Hydra Industries Sponsor LLC ("Hydra Sponsor") an affiliate of Mr. Weil. Mr. Weil is the managing member of Hydra Sponsor, whose membership interests are owned by Mr. Weil and Mr. Weil's children or trusts for their benefit. Mr. Weil has sole voting and dispositive power with respect to such shares. Mr. Weil disclaims beneficial ownership over any securities owned by Hydra Sponsor in which he does not have any pecuniary interest. Each restricted stock unit ("RSU") represents a contingent right to receive one share of common stock at settlement, subject to the terms and conditions set forth in the award of such RSUs by the Company to Mr. Weil under the Company's Second Long-Term Incentive Plan ("Second Incentive Plan"). The Company's Second Incentive Plan was approved by the Board of Directors and is pending stockholder approval. All awards thereunder are contingent upon stockholder approval of the Second Incentive Plan. The RSUs vest on December 31, 2019, or earlier upon the occurrence of a Transformational M&A Transaction, a Change in Control of the Company, or death, disability, termination by the Company without cause or termination by Mr. Weil with good reason, subject to the terms and conditions set forth in the award agreement and the Second Incentive Plan. Settlement of vested RSUs shall not occur until Mr. Weil's services with the Company terminate or in the event of his death or disability, or upon a Change in Control. /s/ George Peng, attorney-in-fact 2017-12-26