Statement of Changes in Beneficial Ownership (4)
November 05 2021 - 5:14PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Levinson Sam |
2. Issuer Name and Ticker or Trading Symbol
CAPITAL SENIOR LIVING CORP
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CSU
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O GF INVESTMENTS, 810 SEVENTH AVENUE, 28TH FLOOR |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/3/2021 |
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(Street)
NEW YORK, NY 10019
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | 11/3/2021 | | X | | 395400 | A | $30.00 | 775307 | I | See Footnote |
| Common Stock | 11/4/2021 | | P | | 330 | A | $27.87 (1) | 775637 | I | See Footnote |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code
(Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) | 8. Price of Derivative Security
(Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Rights (right to buy) | $30.00 | 11/3/2021 | | X | | | 359456 | 9/10/2021 | 10/27/2021 | Common Stock | 395400 | $0 | 0 | I | See Footnote |
| Explanation of Responses: |
| (1) | Reflects weighted average sale price. Actual sale prices ranged from $27.58 to $28.00. The reporting person undertakes to provide upon request by the Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares purchased or sold at each separate price. |
Remarks:
This Form 4 is being filed jointly by Sam Levinson, a United States citizen; Simon Glick, a United States citizen; Seymour Pluchenik, a United States citizen; Silk Partners, LP ("Silk"), a New York limited partnership; Siget, LLC ("Siget"), a Delaware limited liability company; Siget NY Partners, L.P. ("Siget NY"), a Delaware limited partnership; 1271 Associates, LLC ("1271 Associates"), a Delaware limited liability company; and PF Investors, LLC ("PF Investors"), a New York limited liability company. Includes 16,917 shares of Common Stock held by PF Investors (the "PF Investor Shares"). Mr. Pluchenik is a manager of PF Investors, LLC By virtue of this relationship, Mr. Pluchenik may be deemed to beneficially own the shares of Common Stock owned directly by PF Investors. All shares other than the PF Investor Shares are held by Silk Partners, LP. Mr. Levinson is the chief investment officer of Siget NY. Siget NY is the investment manager of and makes investment decisions for Silk. 1271 Associates is the General Partner of Siget NY. Messrs. Glick and Pluchenik are the managing members of 1271 Associates. Siget is the General Partner of Silk. Messrs. Glick and Pluchenik are the managing members of Siget. By virtue of these relationships, each of Siget NY, 1271 Associates, Siget and Messrs. Levinson, Glick and Pluchenik may be deemed to beneficially own the shares of Common Stock owned directly by Silk. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Levinson Sam
C/O GF INVESTMENTS
810 SEVENTH AVENUE, 28TH FLOOR
NEW YORK, NY 10019 |
| X |
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Signatures
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| /s/ Sam Levinson; /s/ Simon Glick; /s/ Seymour Pluchenik; Silk Partners,LP By: /s/ S. Pluchenik; Siget,LLC By: /s/ S. Pluchenik; Siget NY Partners,L.P. By: /s/ S. Pluchenik; 1271 Associates,LLC By: /s/ S. Pluchenik; PF Investors, LLC By: /s/ S. Pluchenik | | 11/5/2021 |
| **Signature of Reporting Person | Date |
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