Ownership Submission
|
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549INITIAL 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
|
|
OMB APPROVAL
|
|
OMB Number:3235-0104Expires:January 31, 2005Estimated average burden hours per response...0.5
|
|
|
1. Name and Address of Reporting Person *
|
|
Chambers Christine
|
|
2. Date of Event Requiring Statement (Month/Day/Year)
2022-08-03
|
3. Issuer Name and Ticker or Trading Symbol
PETMED EXPRESS INC [PETS]
|
|
(Last)
|
(First)
|
(Middle)
|
|
C/O PETMED EXPRESS, INC. , 420 SOUTH CONGRESS AVENUE
|
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
_____ Director
|
_____ 10% Owner
|
|
_____ Officer (give title below)
|
_____ Other (specify below)
|
|
CFO /
|
|
5. If Amendment, Date Original Filed(Month/Day/Year)
|
(Street)
|
|
DELRAY BEACH
|
FL
|
33445
|
|
6. Individual or Join/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
|
|
Table I - Non-Derivative Securities Beneficially Owned
|
|
|
1.Title of Security
|
2. Amount of Securities Beneficially Owned
|
3. Ownership Form: Direct (D) or Indirect (I)
|
4. Nature of Indirect Beneficial Ownership
|
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
|
2. Date Exercisable and Expiration Date
|
3. Title and Amount of Securities Underlying Derivative Security
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
|
6. Nature of Indirect Beneficial Ownership
|
|
Date Exercisable
|
Expriation Date
|
Title
|
Amount or Number of Shares
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
|
Director
|
10% Owner
|
Officer
|
Other
|
Chambers Christine
C/O PETMED EXPRESS, INC.
420 SOUTH CONGRESS AVENUE
DELRAY BEACH, FL33445
|
|
|
CFO
|
|
Signatures
|
/s/ Christine Chambers
|
2022-08-10
|
|
**Signature of Reporting Person
|
Date
|
Explanation of Responses:
|
(*)
|
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)
|
Includes (a) 13,000 shares of restricted stock under the Company's 2016 Employee Equity Compensation Restricted Stock Plan (the "2016 Plan"), which stock restrictions will lapse pro rata on each of August 3, 2023, August 3, 2024 and August 3, 2025, which are subject to forfeiture in the event of termination of employment (except as provided in the restricted stock agreement),and (b) 3,000 shares of performance restricted stock under the 2016 Plan, which performance restricted shares will be based on the attainment of performance criteria equally weighted between adjusted EBITDA and revenue. The shares for each grant will be released from restriction equally over a three (3) year period on the anniversary of the grant date, subject to the attainment of performance criteria in the case of the performance restricted shares. Ms. Chambers retains voting rights over all the shares subject to forfeiture while in escrow.
|
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
