Amended Statement of Beneficial Ownership (3/a)
June 10 2021 - 7:32PM
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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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
*
Goodwin Robert Simon |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/19/2021
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3. Issuer Name and Ticker or Trading Symbol
TILLY'S, INC. [TLYS]
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(Last)
(First)
(Middle)
C/O TILLY'S, 10 WHATNEY |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
See Remarks / |
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(Street)
IRVINE, CA 92618
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
3/25/2021
| 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) |
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 |
| Stock Option (Right to Buy) | (1) | 6/8/2030 | Common Stock | 25000 | $6.92 | D | |
| Explanation of Responses: |
| (1) | The option vests in four equal annual installments on each of the next four anniversaries of the grant date, subject to the Reporting Person's continued employment with or service to the Issuer through the applicable vesting date. |
Remarks:
Title: SVP, General Merchandising Manager. This amendment is being filed solely to amend the original Form 3 filed by the Reporting Person on March 25, 2021 to include the stock option granted on June 8, 2020. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Goodwin Robert Simon
C/O TILLY'S
10 WHATNEY
IRVINE, CA 92618 |
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| See Remarks |
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Signatures
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| /s/ Michael L. Henry, Attorney-in-Fact for Robert Simon Goodwin | | 6/10/2021 |
| **Signature of Reporting Person | Date |
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