SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 10/04/2021 | 3. Issuer Name and Ticker or Trading Symbol Apria, Inc. [ APR ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Restricted Stock Units | (1) | (1) | Common Stock | 1,854 | (2) | D | |
Stock Appreciation Rights | (3) | 05/12/2030 | Common Stock | 7,667 | 5.33 | D | |
Stock Appreciation Rights | (4) | 03/09/2027 | Common Stock | 12,664 | 8.28 | D | |
Stock Appreciation Rights | (4) | 10/08/2029 | Common Stock | 1,916 | 8.28 | D | |
Stock Appreciation Rights | (4) | 12/12/2029 | Common Stock | 3,068 | 8.28 | D | |
Stock Appreciation Rights | (4) | 03/09/2027 | Common Stock | 3,046 | 4.67 | D | |
Stock Appreciation Rights | (5) | 10/08/2029 | Common Stock | 5,749 | 5.33 | D | |
Stock Appreciation Rights | (6) | 12/12/2029 | Common Stock | 12,266 | 5.33 | D | |
Stock Appreciation Rights | (7) | 03/09/2027 | Common Stock | 7,032 | 2.07 | D |
Explanation of Responses: |
1. These restricted stock units vest in three equal annual installments beginning on June 10, 2022, subject to the Reporting Person's continued employment on the applicable vesting date. |
2. Each restricted stock unit represents a contingent right to receive one share of common stock of the Issuer ("Common Stock"). The restricted stock units will be settled in either Common Stock or cash (or a combination thereof) at the discretion of the Issuer's compensation committee. |
3. Of these stock appreciation rights, 1,917 are fully vested and the remainder vest in equal quarterly installments ending on May 12, 2025. |
4. These stock appreciation rights are fully vested. |
5. Of these stock appreciation rights, 1,150 are fully vested and the remainder vest in equal quarterly installments ending on August 15, 2024. |
6. Of these stock appreciation rights, 2,300 are fully vested and the remainder vest in equal quarterly installments ending on December 9, 2024. |
7. Of these stock appreciation rights, 4,221 are fully vested and the remainder vest in equal quarterly installments ending on February 28, 2022. |
Remarks: |
Exhibit List: Exhibit 24 - Power of Attorney. |
/s/ Timothy Maloche, as Attorney-in-Fact | 10/14/2021 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |