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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Isely Kemper 12612 W. ALAMEDA PARKWAY LAKEWOOD, CO 80228 |
X | X | Chairman & Co-President | 13D Group Member |
/s/ Kemper Isely | 05/26/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | No price is entered because the transaction is an exempt bona fide gift of Common Stock to Anthony Andueza, as Custodian for Ritchie K. Isely, the Reporting Person's son, under the Colorado Uniform Transfers to Minors Act. The Reporting Person has no investment power over these shares and disclaims beneficial ownership of these shares. |
(2) | No price is entered because the transaction is an exempt bona fide gift of Common Stock to Raquel M. Isely, the Reporting Person's daughter, who shares the Reporting Person's household. The Reporting Person has no investment power over these shares and disclaims beneficial ownership of these shares |
(3) | The Reporting Person is a member, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
(4) | The Reporting Person is a beneficiary through a member trust, but has no investment power over these shares and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
(5) | The Reporting Person is a beneficiary through a member trust and disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. |
Remarks: The Reporting Person is a party to a Stockholders Agreement entered into in connection with the initial public offering of the issuer's stock that contains voting agreements and thus is a member of a Schedule 13D group that beneficially owns more than 10% of the issuer's common stock. The number of shares identified as beneficially owned by the Reporting Person excludes shares of Common Stock deemed to be beneficially owned by him solely because of this Stockholders Agreement. The original Form 4 filed on December 21, 2015 is amended by this Form 4 amendment to correctly reflect the transaction and the Reporting Person's indirect ownership of Common Stock. |