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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 | |
BRADLEY WILLIAM F JR 25501 WEST VALLEY PARKWAY SUITE 300 OLATHE, KS 66061 |
Exec VP,CAO,Gen Counsel & Secy |
/s/Aimi Daughtery, Attorney-in-Fact for William F. Bradley, Jr. | 01/06/2016 | |
**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 shares surrendered to NIC Inc. by Reporting Person to satisfy tax withholding obligations on vesting of restricted shares granted February 23, 2015. |
(2) | This form is being amended to report the forfeiture of shares from previously reported service-based and performance-based awards. |
(3) | The total shares held by the Reporting Person have been increased by 146 shares to correct errors in tax withholding obligations previously reported. |
(4) | Represents shares surrendered to NIC Inc. by Reporting Person to satisfy tax withholding obligations on vesting of restricted shares granted February 24, 2014. |
(5) | Represents shares surrendered to NIC Inc. by Reporting Person to satisfy tax withholding obligations on vesting of restricted shares granted February 5, 2013. |
(6) | Represents shares surrendered to NIC Inc. by Reporting Person to satisfy tax withholding obligations on vesting of restricted shares granted January 30, 2012. |
(7) | Forfeiture of shares from previously reported performance-based restricted stock award granted on February 24, 2014. |
(8) | Forfeiture of shares from previously reported performance-based restricted stock award granted on February 23, 2015. |
(9) | Forfeiture of shares from previously reported service-based restricted stock award granted on February 24, 2014. |
(10) | Forfeiture of shares from previously reported service-based restricted stock award granted on February 23, 2015. |
(11) | On December 11, 2015, the Reporting Person transferred 250,000 shares from the William F. Bradley, Jr. Trust, dated April 15, 2004, to the William F. Bradley, Jr. Charitable Remainder Unitrust. The Reporting Person is the sole trustee and the sole non-charitable beneficiary of the charitable remainder trust. |