Initial Statement of Beneficial Ownership (3)
07 März 2022 - 11:53PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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Gajial Mohammad Omer |
2. Date of Event Requiring Statement (MM/DD/YYYY)
2/22/2022
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3. Issuer Name and Ticker or Trading Symbol
Albertsons Companies, Inc. [ACI]
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(Last)
(First)
(Middle)
250 E. PARKCENTER BLVD. |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) EVP, Pharmacy & Health / |
(Street)
BOISE, ID 83706
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 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 Beneficially Owned
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1.Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Class A common stock, par value $0.01 | 31433 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Performance-based Restricted Stock Units | (1) | (1) | Class A common stock, par value $0.01 | 34013 | (1) | D | |
Performance-based Restricted Stock Units | (2) | (2) | Class A common stock, par value $0.01 | 20129 | (2) | D | |
Time-based Restricted Stock Units | (3) | (3) | Class A common stock, par value $0.01 | 73696 | (3) | D | |
Time-based Restricted Stock Units | (4) | (4) | Class A common stock, par value $0.01 | 13568 | (4) | D | |
Time-based Restricted Stock Units | (5) | (5) | Class A common stock, par value $0.01 | 25729 | (5) | D | |
Performance-based Restricted Stock Units | (6) | (6) | Class A common stock, par value $0.01 | 25729 | (6) | D | |
Explanation of Responses: |
(1) | Each performance-based restricted stock unit represents a contractual right to receive one share of Class A common stock of the Company. The awards will fully vest on February 25, 2023, as long as the reporting person remains continuously employed through the vesting date. These performance restricted stock units are subject to the attainment of performance goals for 2023 fiscal year of the Company. The reported number of performance restricted stock units represents the "target" amount of the award and the actual number of units earned will depend upon satisfaction of the performance goals. |
(2) | Each performance-based restricted stock unit represents a contractual right to receive one share of Class A common stock of the Company. The awards will fully vest on February 24, 2024, as long as the reporting person remains continuously employed through each vesting date. These performance restricted stock units are subject to the attainment of performance goals for the 2023 and 2024 fiscal years of the Company. The reported number of performance restricted stock units represents the "target" amount of the award and the actual number of units earned will depend upon satisfaction of the performance goals. |
(3) | Each time-based restricted stock unit represents a contractual right to receive one share of Class A common stock of the Company. The awards will vest in three equal annual installments which commenced on October 13, 2021, as long as the reporting person remains continuously employed through each vesting date. |
(4) | Each time-based restricted stock unit represents a contractual right to receive one share of Class A common stock of the Company. The awards will vest in three equal annual installments which commenced on February 26, 2022, as long as the reporting person remains continuously employed through each vesting date. |
(5) | Each time-based restricted stock unit represents a contractual right to receive one share of Class A common stock of Albertsons Companies, Inc. The awards will vest in three equal installments on February 25, 2023, February 24, 2024 and February 22, 2025 as long as the reporting person remains continuously employed through such respective date. |
(6) | Each performance-based restricted stock unit represents a contractual right to receive one share of Class A common stock of the Company. These performance restricted stock units are subject to the attainment of performance goals for the 2022, 2023 and 2024 fiscal years of the Company. The reported number of performance restricted stock units represents the "target" amount of the award and the actual number of units earned will depend upon satisfaction of the performance goals. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Gajial Mohammad Omer 250 E. PARKCENTER BLVD. BOISE, ID 83706 |
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| EVP, Pharmacy & Health |
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Signatures
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/s/ Bipasha Mukherjee, attorney-in-fact | | 3/4/2022 |
**Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* | If the form is filed by more than one reporting person, see Instruction 5(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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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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