Initial Statement of Beneficial Ownership (3)
September 30 2021 - 6:04PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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1. Name and Address of Reporting Person
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Dvorak Kerrie |
2. Date of Event Requiring Statement (MM/DD/YYYY)
9/20/2021
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3. Issuer Name and Ticker or Trading Symbol
Groupon, Inc. [GRPN]
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(Last)
(First)
(Middle)
600 W CHICAGO AVE |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
Interim CAO / |
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(Street)
CHICAGO, IL 60654
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 1075 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 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) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Restricted Stock Units | 11/20/2021 | (1) | Common Stock | 1539.0 | (2) | D | |
| Restricted Stock Units | 5/20/2022 | (3) | Common Stock | 1848.0 | (2) | D | |
| Restricted Stock Units | 6/5/2022 | (4) | Common Stock | 237.0 | (2) | D | |
| Explanation of Responses: |
| (1) | 1,026 RSUs reported on this line will vest on November 20, 2021 and 513 RSUs will vest on March 20, 2022, in each case subject to Ms. Dvorak's continued employment with the Company through each vesting date. |
| (2) | Each restricted stock unit represents a contingent right to receive one share of Common Stock. |
| (3) | The RSUs reported on this line vest in two equal installments on May 20, 2022 and May 20, 2023, subject to Ms. Dvorak's continued employment with the Company through each vesting date. |
| (4) | The RSUs reported on this line vest on June 5, 2022, subject to Ms. Dvorak's continued employment with the Company through the vesting date. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Dvorak Kerrie
600 W CHICAGO AVE
CHICAGO, IL 60654 |
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| Interim CAO |
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Signatures
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| /s/ Erin G. Stone | | 9/30/2021 |
| **Signature of Reporting Person | Date |
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