Intentional misstatements or omissions of facts constitute Federal Criminal Violations. If the form is filed by more than one reporting person, see Instruction 4(b)(v). Signatures /s/ Steve Dean, by power of attorney Reporting Owners Reporting Owner Name / Address Ownership Form of Derivative Security: Direct (D) or Indirect (I)ġ1. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)ġ0. Title and Amount of Underlying Securitiesĩ. Number of Derivative Securities Acquired (A) or Disposed of (D)ħ. Deemed Execution Date, if any (Month/Day/Year)ĥ. Conversion or Exercise Price of Derivative SecurityģA. ( e.g., puts, calls, warrants, options, convertible securities) 1. Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned 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. Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Ownership Form: Direct (D) or Indirect (I)ħ. Amount of Securities Beneficially Owned Following Reported Transaction(s)Ħ. Securities Acquired (A) or Disposed of (D)ĥ. Deemed Execution Date, if any (Month/Day/Year)Ĥ. Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially OwnedĢA. _ Form filed by More than One Reporting Person Individual or Joint/Group Filing (Check Applicable Line) If Amendment, Date Original Filed (Month/Day/Year)Ħ. Date of Earliest Transaction (Month/Day/Year)Ĥ. Relationship of Reporting Person(s) to Issuerģ. Issuer Name and Ticker or Trading Symbolĥ. STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIESįiled 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 1940Įstimated average burden hours per response. UNITED STATES SECURITIES AND EXCHANGE COMMISSION Form 4 or Form 5 obligations may continue. Check this box if no longer subject to Section 16.
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