Sec Form 4 Filing - Quezada Carlos R. @ CARRIAGE SERVICES INC - 2021-09-01

Insider filing report for Changes in Beneficial Ownership
"Insiders might sell their shares for any number of reasons, but they buy them for only one: they think the price will rise"
- Peter Lynch
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The following is an SEC EDGAR document rendered as filed.
Here is the list of insider trading transaction codes

Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Washington, D.C. 20549
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
OMB Number: 3235-0287
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1. Name and Address of Reporting Person *
Quezada Carlos R.
2. Issuer Name and Ticker or Trading Symbol
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
EVP & Chief Operating Officer
3. Date of Earliest Transaction (MM/DD/YY)
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/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
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/01/2021 M 6,667 A $ 18.02 11,366 D
Common Stock 09/01/2021 F 2,657 ( 1 ) D $ 47.2 8,709 D
Common Stock 09/01/2021 S 4,010 ( 2 ) D $ 47.45 4,699 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options $ 18.02 09/01/2021 M 6,667 ( 3 ) 06/25/2030 Common Stock 6,667 $ 18.02 13,333 D
Performance Award ( 4 ) ( 4 ) 12/31/2024 Common Stock 13,974 13,974 D
Stock Options $ 34.79 ( 5 ) 02/17/2031 Common Stock 50,000 50,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Quezada Carlos R.
EVP & Chief Operating Officer
/s/ Carlos Quezada 09/03/2021
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents shares withheld on 9/1/2021 to cover the option price and taxes associated with the exercise of stock options.
( 2 )The price reported in column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $47.44 to $47.53, inclusive. The reporting person undertakes to provide to Carriage Services, Inc. any security holder of Carriage Services. Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote.
( 3 )Stock Options granted pursuant to the Carriage Services, Inc. 2017 Omnibus Plan of which 1/3 vested on 6/25/2021 and 1/3 will vest each year on 6/25/2022 and 6/25/2023. 6,667 options were exercised on 9/1/2021. The options expire on 6/25/2030.
( 4 )Pursuant to the 2017 Omnibus Plan, the target share awards for the eligible employee will vest on December 31, 2024 if the Company's common stock reaches one of five pre-determined growth targets for a sustained period beginning on the grant date of June 25, 2020 and ending on December 31, 2024.
( 5 )Stock Options granted on 2/17/2021 pursuant to the Carriage Services, Inc. 2017 Omnibus Incentive Plan that will vest in equal 20% increments each year over the next five years. The options expire on 2/17/2031.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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