Statement of Changes in Beneficial Ownership (4)
25 Juni 2021 - 10:08PM
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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3235-0287
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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
*
Bird Lewis L III |
2. Issuer Name and Ticker or Trading Symbol
At Home Group Inc.
[
HOME
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) CHAIRMAN AND CEO |
(Last)
(First)
(Middle)
AT HOME GROUP INC., 1600 EAST PLANO PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
6/24/2021 |
(Street)
PLANO, TX 75074
(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 | 6/24/2021 | | G |
V
| 5270 | D | $0 (1) | 27730 | D | |
Common Stock | 6/24/2021 | | G |
V
| 5055 | D | $0 (1) | 64005 | I | Held in name of Bird Family Trust (2) |
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 |
Explanation of Responses: |
(1) | This transaction represents a gift / charitable donation effective June 24, 2021 to Ithaca College, and represents the second and final donation made pursuant to an Endowed Fund Agreement entered into in January 2018. This is not a market transaction, thus no price has been reported and no value was received for the gifted shares of the Issuer's common stock. |
(2) | The reporting person beneficially owns these shares indirectly through the revocable Bird Family Trust (the "Trust"). The reporting person and his wife serve as the trustees and are the beneficiaries of the Trust. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Bird Lewis L III AT HOME GROUP INC. 1600 EAST PLANO PARKWAY PLANO, TX 75074 | X |
| CHAIRMAN AND CEO |
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Signatures
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/s/ Mary Jane Broussard, Attorney-in-Fact | | 6/25/2021 |
**Signature of Reporting Person | Date |
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