Statement of Changes in Beneficial Ownership (4)
21 Mai 2022 - 01:53AM
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).
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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 * MAKOWSKI TIM A |
2. Issuer Name and Ticker or Trading
Symbol ADVANCED DRAINAGE SYSTEMS, INC. [ WMS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
See Remarks |
(Last)
(First)
(Middle)
C/O ADVANCED DRAINAGE SYSTEMS, INC., 4640 TRUEMAN
BOULEVARD |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/18/2022
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(Street)
HILLIARD, OH 43026
(City)
(State)
(Zip)
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4. 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 |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
5/18/2022 |
|
A |
|
6717 (1) |
A |
$0.00 |
14070 |
D |
|
Common Stock |
5/18/2022 |
|
A |
|
1008 |
A |
$0.00 |
15078 |
D |
|
Common Stock |
5/18/2022 |
|
F |
|
1934 |
D |
$99.29 |
13144 |
D |
|
Common Stock |
5/18/2022 |
|
F |
|
103 |
D |
$99.29 |
13041 |
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) |
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 |
Option to Purchase Common
Stock |
$99.29 |
5/18/2022 |
|
A |
|
2416 |
|
(2) |
5/17/2032 |
Common Stock |
2416 |
$0.00 |
2416 |
D |
|
Explanation of
Responses: |
(1) |
Reflects grant of
performance-based units, orginally granted pursuant to the Issuer's
2017 Omnibus Incentive Plan, earned after the Issuer determined
that certain performance goals for the performance period ended
March 31, 2022 had been met. Total includes dividend equivalents in
the amount of 339 shares, which dividend equivalents are settled in
common stock. |
(2) |
The options vest in three
equal annual installments beginning on May 17, 2023, provided that
the Reporting Person remains continuously employed by the Issuer
through each applicable vesting date. |
Remarks:
Vice President, Controller and Chief Accounting Officer |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
MAKOWSKI TIM A
C/O ADVANCED DRAINAGE SYSTEMS, INC.
4640 TRUEMAN BOULEVARD
HILLIARD, OH 43026 |
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|
See Remarks |
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Signatures
|
/s/ Tim A. Makowski, by Scott A. Cottrill as
attorney-in-fact |
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5/20/2022 |
**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 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). |
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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