Statement of Changes in Beneficial Ownership (4)
February 04 2016 - 10:11AM
Edgar (US Regulatory)
FORM 4
[
X
]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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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
*
Stern David Ross
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2. Issuer Name
and
Ticker or Trading Symbol
PEP BOYS MANNY MOE & JACK
[
PBY
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
EVP - Chief Financial Officer
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(Last)
(First)
(Middle)
3111 WEST ALLEGHENY AVENUE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/4/2016
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(Street)
PHILADELPHIA, PA 19132
(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
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2/4/2016
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U
(1)
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43354
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D
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$18.50
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0
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D
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Common Stock
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2/4/2016
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U
(1)
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4162
(2)
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D
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$18.50
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0
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D
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Common Stock
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2/4/2016
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U
(1)
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2108
(3)
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D
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$18.50
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0
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D
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Option (right to buy)
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$11.86
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2/4/2016
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D
(1)
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15355
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2/4/2016
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3/13/2020
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Common Stock
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15355
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(4)
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0
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D
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Option (right to buy)
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$10.38
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2/4/2016
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D
(1)
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40907
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2/4/2016
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4/18/2021
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Common Stock
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40907
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(4)
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0
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D
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Option (right to buy)
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$9.25
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2/4/2016
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D
(1)
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53448
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2/4/2016
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4/28/2022
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Common Stock
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53448
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(4)
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0
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D
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TSR Performance-Based Award
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(4)
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2/4/2016
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D
(1)
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3376
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2/4/2016
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(4)
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Common Stock
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5908
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(4)
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0
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D
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ROIC Performance-Based Award
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(4)
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2/4/2016
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D
(1)
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6751
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2/4/2016
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(4)
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Common Stock
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10127
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(4)
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0
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D
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TSR Performance-Based Award
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(4)
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2/4/2016
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D
(1)
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5276
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2/4/2016
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(4)
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Common Stock
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9233
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(4)
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0
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D
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ROIC Performance-Based Award
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(4)
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2/4/2016
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D
(1)
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10552
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2/4/2016
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(4)
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Common Stock
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15828
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(4)
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0
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D
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TSR Performance Based Award
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(4)
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2/4/2016
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D
(1)
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6047
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2/4/2016
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(4)
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Common Stock
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10582
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(4)
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0
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D
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ROIC Performance-Based Award
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(4)
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2/4/2016
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D
(1)
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12094
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2/4/2016
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(4)
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Common Stock
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18141
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(4)
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0
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D
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Explanation of Responses:
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(
1)
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On February 3, 2016, Icahn Enterprises Holdings L.P. acquired the issuer pursuant to that certain agreement and plan of merger, dated December 30, 2015, by and among Icahn Enterprises Holdings L.P., IEP Parts Acquisition LLC and the issuer. At the effective time of the merger, each outstanding share of the issuer's common stock was converted into the right to receive $18.50 in cash (the "per share merger consideration"). In addition, at the effective time of the merger, each outstanding restricted stock unit, performance stock unit and notional investment convertible into the issuer's common stock, whether or not vested, was converted into the right to receive the per share merger consideration. Finally, each outstanding option to acquire the issuer's common stock, whether or not vested, was converted into the right to receive the per share merger consideration less the exercise price of such option.
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(
2)
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Represents shares held in the Reporting Person's Account under The Pep Boys Deferred Compensation Plan.
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(
3)
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Represents the number of shares held in the Reporting Person's account under The Pep Boys Savings Plan, as reflected in his last plan statement.
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(
4)
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Not applicable.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Stern David Ross
3111 WEST ALLEGHENY AVENUE
PHILADELPHIA, PA 19132
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EVP - Chief Financial Officer
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Signatures
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David R. Stern
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2/4/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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