- Statement of Changes in Beneficial Ownership (4)
06 Abril 2011 - 7:18PM
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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February 28, 2011
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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(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Kelly Ronald Eugene
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2. Issuer Name
and
Ticker or Trading Symbol
DRUGSTORE COM INC
[
DSCM
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
VP, Customer & Pharmacy Ops
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(Last)
(First)
(Middle)
411 108TH AVE SE, SUITE 1400
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3. Date of Earliest Transaction
(MM/DD/YYYY)
4/4/2011
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(Street)
BELLEVUE, WA 98004
(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
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4/4/2011
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F
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4998
(1)
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D
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$3.84
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77794
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D
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Common Stock
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4/4/2011
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M
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7500
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A
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$0
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85294
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D
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Common Stock
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4/4/2011
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E
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1983
(2)
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D
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$3.84
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83311
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Restricted Stock Unit
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$0
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4/4/2011
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M
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7500
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10/3/2010
(3)
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10/3/2014
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Common Stock
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7500
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$0
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52500
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D
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Explanation of Responses:
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(
1)
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Represents shares of Common Stock withheld by the issuer to satisfy taxes due in connection with the vesting of shares of Restricted Stock.
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(
2)
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Represents shares of Common Stock withheld by the issuer to satisfy taxes due in connection with the vesting of restrictd stock unit shares.
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(
3)
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Indicates vesting commencement date; the restricted stock unit ("RSU") become exercisable as to the RSUs'original share total over 48 months, at the rate of one-eighth on each six month anniversary of the vesting commencement date until all shares are fully vested, subject to awardee continuing to be a Service Provider.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Kelly Ronald Eugene
411 108TH AVE SE
SUITE 1400
BELLEVUE, WA 98004
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VP, Customer & Pharmacy Ops
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Signatures
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/s/ Cabrelle Abel, by Power of Attorney
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4/6/2011
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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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