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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 | |
HELEN SUZANNE L C/O MOHAWK INDUSTRIES INC 2001 ANTIOCH ROAD DALTON, GA 30721 |
Possible member of group |
/s/ Suzanne Helen | 10/10/2017 | |
**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) | For estate planning purposes, Reporting Person transferred for no consideration her pecuniary interest in the 420,935 shares held by the SLH Partners LP to other legal entities for the benefit of her children and her descendants. Reporting Person no longer has a pecuniary interest in SLH Partners LP; therefore, the Reporting Person no longer has a beneficial interest in those shares for Section 16 purposes. |
(2) | Reporting Person may be considered a member of a "group" with certain family members and entities formed for the benefit of certain family members; however, Reporting Person disclaims the existence of such a "group" and disclaims beneficial ownership of any shares not reported herein and any shares in which she has no pecuniary interest. |
(3) | Reporting Person is one of three family members who share equal control over the general partner of this limited partnership. Reporting Person disclaims beneficial ownership in the number of shares held by the limited partnership to the extent that she does not have a pecuniary interest. |
(4) | Since the last Form 4 filing, Reporting Person transferred 103,700 shares held directly to SLH Fund LP in exchange for a limited partnership interest. Since Reporting Person retained investment power and voting power over the shares held by SLH Fund LP and retains the pecuniary interest in those shares, the transaction was treated as a change in the form of beneficial ownership and was exempt from reporting and matching pursuant to Rule 16a-13. |