Ownership Submission
|
FORM 4/A
|
|
Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
|
|
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 or Section 30(h) of the Investment Company Act of 1940
|
|
OMB APPROVAL
|
|
OMB Number:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
|
|
|
1. Name and Address of Reporting Person *
|
|
Larson Timothy Mark
|
|
2. Issuer Name and Ticker or Trading Symbol
Skyline Champion Corp [SKY]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
_____ Director
|
_____ 10% Owner
|
|
_____ Officer (give title below)
|
_____ Other (specify below)
|
|
Chief Growth Officer /
|
|
|
(Last)
|
(First)
|
(Middle)
|
|
C/O SKYLINE CHAMPION CORPORATION , 755 W. BIG BEAVER ROAD, SUITE 1000
|
|
3. Date of Earliest Transaction (Month/Day/Year)
|
|
|
4. If Amendment, Date Original Filed(Month/Day/Year)
2024-04-02
|
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 Acquired, Disposed of, or Beneficially Owned
|
|
|
1.Title of Security
|
2. Transaction Date (Month/Day/Year)
|
2A. Deemed Execution Date, if any (Month/Day/Year)
|
3. Transaction Code
|
4. Securities Acquired (A) or Disposed of (D)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
|
6. Ownership Form: Direct (D) or Indirect (I)
|
7. Nature of Indirect Beneficial Ownership
|
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
|
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
|
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
|
6. Date Exercisable and Expiration Date
|
7. Title and Amount of Securities Underlying Derivative Security
|
8. Price of Derivative Security
|
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
|
11. Nature of Indirect Beneficial Ownership
|
|
Code
|
V
|
(A)
|
(D)
|
Date Exercisable
|
Expriation Date
|
Title
|
Amount or Number of Shares
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
|
Director
|
10% Owner
|
Officer
|
Other
|
Larson Timothy Mark
C/O SKYLINE CHAMPION CORPORATION
755 W. BIG BEAVER ROAD, SUITE 1000
TROY, MI48084
|
|
|
Chief Growth Officer
|
|
Signatures
|
/s/ Caren A. Ries, Attorney-in-Fact
|
2024-04-25
|
|
**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)
|
Represents restricted stock units ("RSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan as amended following the discovery of a computational error since the original April 2, 2024 filing. Each RSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the RSUs, one third of the RSUs vests on each of the first three anniversaries of March 29, 2024, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date.
|
|
(2)
|
Represents performance-based restricted stock units ("PRSUs") granted to the Reporting Person under the Issuer's 2018 Equity Incentive Plan as amended following the discovery of a computational error since the original April 2, 2024 filing. Each PRSU represents the contingent right to receive one share of Common Stock. Subject to the terms of the award agreement evidencing the grant of the PRSUs, vesting of a percentage of the PRSUs (including up to 200%) is 60% dependent on the total shareholder return of Issuer from March 29, 2024 through March 29, 2027 relative to the total shareholder return of certain other companies over that same time period, and 40% dependent on the market share of single family completions of Issuer as of January 31, 2026, provided that the Reporting Person remains in continuous service with the Issuer through each vesting date.
|
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.
