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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, 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. | SEC 1473 (7-02) | ||
| 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. | |||
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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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Employee Stock Option (right to buy) | (2) | 12/18/2029 | Common Stock | 75,000 | $ 1.2 | D | |
| Employee Stock Option (right to buy) | (3) | 12/03/2030 | Common Stock | 37,500 | $ 1.71 | D | |
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Trost Keith Edward Jr C/O STONEMOR INC., 3331 STREET RD., SUITE 200 BENSALEM, PA 19020 |
See Remarks | |||
| /s/ Keith Edward Trost, Jr. | 06/15/2022 | |
| **Signature of Reporting Person | Date |
| * | 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). |
| (1) | Represents 37,500 restricted shares of common stock of StoneMor Inc. granted to the reporting person on December 3, 2020 under the StoneMor Amended and Restated 2019 Long-Term Incentive Plan, as amended (the "Plan"), which vest in equal annual installments over a three-year period, commencing on the first anniversary following the date of grant. |
| (2) | Represents 75,000 options to purchase common stock of StoneMor Inc. granted to the reporting person on December 18, 2019 under the Plan, which vest in equal annual installments over a three-year period, commencing on the first anniversary following the date of grant. |
| (3) | Represents 37,500 options to purchase common stock of StoneMor Inc. granted to the reporting person on December 3, 2020 under the Plan, which vest in equal annual installments over a three-year period, commencing on the first anniversary following the date of grant. |
| Remarks: Senior Vice President of Corporate Development Exhibit List - Exhibit 24 - Power of Attorney |
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