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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 | ||||||||
Performance Share Units | (1) | 03/01/2016 | M | 9,504 | (1) | (1) | Common Stock | 9,504 | $ 0 (4) | 15,426 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sjostrom Sharon 9135 S. RIDGELINE BLVD., SUITE 200 C/O ADVANCED EMISSIONS SOLUTIONS, INC. HIGHLANDS RANCH, CO 80129 |
Chief Product Officer |
/s/ Sharon Sjostrom | 03/03/2016 | |
**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) | On March 1, 2016, the Compensation Committee of the Board of Directors of the issuer determined that of the 9,504 performance share units ("PSUs") awarded to the reporting person on May 14, 2013 (adjusted for the 2:1 stock dividend in March 2014) pursuant to the 2013 Long Term Incentive Plan under the issuer's Amended and Restated 2007 Equity Incentive Plan, as amended (the "2007 Plan"), 3,231 PSUs vested based on the achievement of specific performance criteria over a three year performance period ended December 31, 2015. Each vested PSU represents the right to receive one share of the issuer's common stock. |
(2) | Common stock was issued pursuant to the vesting terms of the PSUs, which were granted for services rendered to the Company by the reporting person. |
(3) | Of the amount shown, 16,532 shares are held in a qualified pension plan account of the reporting person and 4,180 shares are restricted stock (not fully vested and subject to certain repurchase rights or transfer restrictions under the 2007 Plan). |
(4) | The PSUs were granted for services rendered to the Company by the reporting person. |