SEC Form 4
FORM 4
Check this box if no longer subject
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to Section 16. Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION | |||
OMB APPROVAL | |||
Washington, D.C. 20549 | |||
OMB Number: | 3235-0287 | ||
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP | Estimated average burden | ||
hours per response: | 0.5 | ||
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
1. Name and Address of Reporting Person*
Polle Gregg
(Last) | (First) | (Middle) |
C/O MONTICELLO CASINO AND RACEWAY, 204 STATE ROUTE 17B, P.O. BOX 5013
(Street) | |
MONTICELLO NY | 12701 |
2. | Issuer Name and Ticker or Trading Symbol | 5. Relationship of Reporting Person(s) to Issuer | ||
EMPIRE RESORTS INC[ NYNY ] | (Check all applicable) | |||
X Director | 10% Owner | |||
3. | Date of Earliest Transaction (Month/Day/Year) | |||
Officer (give title | Other (specify | |||
07/17/2019 | ||||
below) | below) | |||
4. | If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable | ||
Line) | ||||
X Form filed by One Reporting Person | ||||
Form filed by More than One Reporting | ||||
Person |
(City)(State)(Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) | 2. Transaction | 2A. Deemed | 3. | 4. Securities Acquired (A) or | 5. Amount of | 6. Ownership | 7. Nature | |||||||||||||||||||||||
Date | Execution Date, | Transaction | Disposed Of (D) (Instr. 3, 4 | Securities | Form: Direct | of Indirect | ||||||||||||||||||||||||
(Month/Day/Year) | if any | Code (Instr. | and 5) | Beneficially | (D) or | Beneficial | ||||||||||||||||||||||||
(Month/Day/Year) | 8) | Owned | Indirect (I) | Ownership | ||||||||||||||||||||||||||
Following | (Instr. 4) | (Instr. 4) | ||||||||||||||||||||||||||||
Code | V | Amount | (A) or | Price | Reported | |||||||||||||||||||||||||
Transaction(s) | ||||||||||||||||||||||||||||||
(D) | ||||||||||||||||||||||||||||||
(Instr. 3 and 4) | ||||||||||||||||||||||||||||||
Common Stock | 07/17/2019 | A | 6,400(1) | D | $0.00 | 38,576 | D | |||||||||||||||||||||||
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||||||||||||||||||||||
(e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||||||||||||||||||
1. Title of | 2. | 3. Transaction | 3A. Deemed | 4. | 5. | 6. Date Exercisable and | 7. Title and | 8. Price | 9. Number of | 10. | 11. Nature | |||||||||||||||||||
Derivative | Conversion | Date | Execution Date, | Transaction | Number | Expiration Date | Amount of | of | derivative | Ownership | of Indirect | |||||||||||||||||||
Security | or Exercise | (Month/Day/Year) | if any | Code (Instr. | of | (Month/Day/Year) | Securities | Derivative | Securities | Form: | Beneficial | |||||||||||||||||||
(Instr. 3) | Price of | (Month/Day/Year) | 8) | Derivative | Underlying | Security | Beneficially | Direct (D) | Ownership | |||||||||||||||||||||
Derivative | Securities | Derivative | (Instr. 5) | Owned | or Indirect | (Instr. 4) | ||||||||||||||||||||||||
Security | Acquired | Security (Instr. 3 | Following | (I) (Instr. | ||||||||||||||||||||||||||
(A) or | and 4) | Reported | 4) | |||||||||||||||||||||||||||
Disposed | Transaction(s) | |||||||||||||||||||||||||||||
of (D) | (Instr. 4) | |||||||||||||||||||||||||||||
(Instr. 3, | ||||||||||||||||||||||||||||||
4 and 5) | ||||||||||||||||||||||||||||||
Amount | ||||||||||||||||||||||||||||||
or | ||||||||||||||||||||||||||||||
Number | ||||||||||||||||||||||||||||||
Date | Expiration | of | ||||||||||||||||||||||||||||
Code | V | (A) | (D) | Exercisable | Date | Title | Shares | |||||||||||||||||||||||
Common | ||||||||||||||||||||||||||||||
Restricted | Stock, | 6,400 | ||||||||||||||||||||||||||||
Stock | (2) | 07/17/2019 | M | 6,400 | (1) | (1) | par value | $0.00 | 0 | D | ||||||||||||||||||||
Units | $.01 per | |||||||||||||||||||||||||||||
share | ||||||||||||||||||||||||||||||
Explanation of Responses:
- Represents shares of common stock of Empire Resorts, Inc. (the "Company") issued upon accelerated vesting of restricted stock units ("RSUs") granted to Mr. Polle on May 6, 2019 under the Empire Resorts, Inc. 2015 Equity Incentive Plan, as amended (the "Plan"), as a result of Mr. Polle's resignation from the Company on July 17, 2019 (the "Resignation Date").
- Each RSU represented a contingent right to receive one (1) share of common stock of the Company.
Remarks:
/s/ Ryan Eller, President and | 07/19/2019 |
Chief Executive Officer | |
** 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 4 (b)(v).
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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). 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.
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Disclaimer
Empire Resorts Inc. published this content on 19 July 2019 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 19 July 2019 15:44:05 UTC