Sec Form 4 Filing - Anderson Keith A @ Skyline Champion Corp - 2021-07-12

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
Anderson Keith A
2. Issuer Name and Ticker or Trading Symbol
Skyline Champion Corp [ SKY]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O SKYLINE CHAMPION CORPORATION, 755 W. BIG BEAVER RD, SUITE 1000
3. Date of Earliest Transaction (MM/DD/YY)
07/12/2021
(Street)
TROY, MI48084
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 07/12/2021 F 11,571 ( 1 ) D $ 54.94 285,377 ( 2 ) 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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Anderson Keith A
C/O SKYLINE CHAMPION CORPORATION
755 W. BIG BEAVER RD, SUITE 1000
TROY, MI48084
X
Signatures
/s/ Caren A. Ries, Attorney-in-Fact 07/14/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares withheld by the Issuer to satisfy the tax withholding obligations of the Reporting Person in connection with the vesting and delivery of performance-based restricted stock units (PRSUs) following the Compensation Committee certification of the achievement of performance goals on July 12, 2021.
( 2 )The amount of securities owned reflects the forfeiture of a portion of PRSUs previously granted to the Reporting Person under the 2018 Equity Incentive Plan of Issuer and reported as owned directly at the target (100%) level. Pursuant to the terms of the award agreement evidencing the grant of the PRSUs, upon the Compensation Committee certification of the achievement of the performance goals on July 12, 2021, the PRSUs vested at 58% of the initial grant based upon the total shareholder return from July 1, 2018 through July 1, 2021 relative to the total shareholder return of certain designated companies over that same time period, and the PRSUs that did not vest were forfeited.

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).
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