Sec Form 4 Filing - Grijalva Laurie Marie @ Boot Barn Holdings, Inc. - 2019-11-13

Insider filing report for Changes in Beneficial Ownership
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FORM 4
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. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
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1. Name and Address of Reporting Person
Grijalva Laurie Marie
2. Issuer Name and Ticker or Trading Symbol
Boot Barn Holdings, Inc. [ BOOT]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Merchandise Officer
(Last) (First) (Middle)
C/O BOOT BARN HOLDINGS, INC., 15345 BARRANCA PKWY
3. Date of Earliest Transaction (MM/DD/YY)
11/13/2019
(Street)
IRVINE, CA92618
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
(City) (State) (Zip)
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 11/13/2019 M 10,123 A $ 6.15 12,245 D
Common Stock 11/13/2019 S 10,123 D $ 42.4855 ( 1 ) 2,122 ( 2 ) D
Common Stock 9,505 ( 3 ) 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
(MM/DD/YY)
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
Options $ 6.15 11/13/2019 M 10,123 ( 4 ) 06/05/2025 Common Stock 10,123 $ 0 20,247 ( 4 ) D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Grijalva Laurie Marie
C/O BOOT BARN HOLDINGS, INC.
15345 BARRANCA PKWY
IRVINE, CA92618
Chief Merchandise Officer
Signatures
/s/ Laurie Marie Grijalva 11/15/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Reflects the weighted average price of sales on November 13, 2019. The shares were sold in multiple transactions at prices ranging from $42.3900 to $42.5900, inclusive. The reporting person undertakes to provide to Boot Barn Holdings, Inc., any security holder of Boot Barn Holdings, 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 such range.
( 2 )Consists of the total number of shares of common stock held by the reporting person as of November 13, 2019, excluding any shares of common stock subject to further vesting conditions.
( 3 )Consists of the total number of shares of common stock underlying restricted stock units held by the reporting person as of November 13, 2019 that remain subject to time-based vesting.
( 4 )The options were granted under the Company's 2014 Equity Incentive Plan and are fully vested and currently exercisable. The remaining options beneficially owned remain subject to future vesting.

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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