SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
4055 TECHNOLOGY FOREST BLVD., SUITE 210 |
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(Street)
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2. Issuer Name and Ticker or Trading Symbol
CONNS INC
[ CONN ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
President- Retail |
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3. Date of Earliest Transaction
(Month/Day/Year) 12/08/2016
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
12/08/2016 |
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S |
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62,749 |
D |
$12.9775
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139,134 |
D |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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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 |
Explanation of Responses: |
Remarks: |
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/s/ Mark L. Prior, as attorney in fact |
12/12/2016 |
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** 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). |
** 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. |
LIMITED POWER OF ATTORNEY FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby makes, constitutes
and appoints
each of Mark Prior, Michael J. Poppe and Lee wright each acting individually, as
the undersigned's true
and lawful attorney-in-fact, with full power and authority as hereinafter
described on behalf of
and in the name, place and stead of the undersigned to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5
(including any
amendments thereto) with respect to the securities of Conn's, Inc., a Delaware
corporation (the
"Company"), with the United States Securities and Exchange Commission, any
national
securities exchanges and the Company, as considered necessary or advisable under
Section 16(a)
of the Securities Exchange Act of 1934 and the rules and regulations promulgated
thereunder, as
amended from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and on the
undersigned's
behalf, information on transactions in the Company's securities from any third
party, including
brokers, employee benefit plan administrators and trustees, and the undersigned
hereby
authorizes any such person to release any such information to each of the
undersigned's
attorneys-in-fact appointed by this Power of Attorney and approves and ratifies
any such release
of information; and
(3) perform any and all other acts which in the discretion of such
attorney-in-fact are
necessary or desirable for and on behalf of the undersigned in connection with
the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, each such
attorney-in-fact
to act in their discretion on information provided to such attorney-in-fact
without independent
verification of such information;
(2) any documents prepared and/or executed by either such attorney-in-fact
on behalf
of the undersigned pursuant to this Power of Attorney will be in such form and
will contain such
information and disclosure as such attorney-in-fact, in his or her discretion,
deems necessary or
desirable;
(3) neither the Company nor either of such attorneys-in-fact assumes (i)
any liability
for the undersigned's responsibility to comply with the requirement of the
Exchange Act, (ii) any
liability of the undersigned for any failure to comply with such requirements,
or (iii) any
obligation or liability of the undersigned for profit disgorgement under Section
16(b) of the
Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from
responsibility for
compliance with the undersigned's obligations under the Exchange Act, including
without
limitation the reporting requirements under Section 16 of the Exchange Act.
The undersigned hereby gives and grants each of the foregoing
attorneys-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite,
necessary or appropriate to be done in and about the foregoing matters as fully
to all intents and
purposes as the undersigned might or could do if present, hereby ratifying all
that each such
attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or
cause to be done
by virtue of this Limited Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked
by the
undersigned in a signed writing delivered to each such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be
executed as of this 12th day of December, 2016.
/s/ David W. Trahan
Signature
David W. Trahan
Print Name