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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 | |
PATSLEY PAMELA H 2828 NORTH HARWOOD STREET 15TH FLOOR DALLAS, TX 75201 |
Former Executive Chairman |
/s/ F. Aaron Henry, attorney-in-fact | 02/05/2018 | |
**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) | Represents the number of shares withheld for the payment of tax liabilities in connection with the vesting, pursuant to the Employment Agreement, dated as of July 30, 2015 (as amended), by and between MoneyGram International, Inc. and Pamela H. Patsley, of (i) 107,900 time-based RSUs and 107,684 performance-based RSUs that were granted on February 25, 2015, (ii) 128,018 time-based RSUs and 24,569 performance-based RSUs that were granted on February 23, 2016 and (iii) 76,651 time-based RSUs and 38,326 performance-based RSUs that were granted on February 22, 2017. |
(2) | The price was determined based on the closing price of $11.65 per share of MoneyGram International, Inc.'s common stock on February 2, 2018. |