SEC FORM 4 SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
VASSALLUZZO SCOTT J

(Last) (First) (Middle)
C/O PRESCOTT INVESTORS, INC.
2200 BUTTS ROAD, SUITE 320

(Street)
BOCA RATON FL 33431

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CIMPRESS N.V. [ CMPR ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) X Other (specify below)
Member of Section 13(d) Group
3. Date of Earliest Transaction (Month/Day/Year)
11/17/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
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 (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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
Ordinary Shares 11/17/2015 A 1,349(1) A $0.00 1,349 D
Ordinary Shares 72,174 I By Scott Vassalluzzo Family Accounts(2)
Ordinary Shares 138,566 I By Prescott Investors Profit Sharing Trust(3)
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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
Share Option (right to buy) $81.52 11/17/2015 A 1,309 02/17/2016(4) 11/17/2025 Ordinary Shares 1,309 $0.00 1,309 D
Explanation of Responses:
1. The reporting person does not directly own these shares at this time. These shares are restricted share units ("RSUs"); each RSU represents Cimpress' commitment to issue one ordinary share when the RSU vests. These RSUs vest at a rate of 12.5% of the original number of RSUs each successive three-month period following the grant date until the second anniversary of the grant date.
2. These shares are owned directly by investment accounts established for the benefit of certain family members of the reporting person. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership for purposes of Section 16 or any other purpose and the reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
3. These shares are owned directly by the Prescott Investors Profit Sharing Trust and are beneficially owned indirectly by the reporting person as a trustee of the Trust. The reporting person disclaims beneficial ownership of these shares in excess of his pecuniary interest therein.
4. This option vests at a rate of 8.33% of the original number of ordinary shares subject to the option each successive three-month period following the grant date until the third anniversary of the grant date.
Remarks:
/s/Kathryn L. Leach as Attorney in Fact for Scott Vassalluzzo 11/19/2015
** Signature of Reporting Person Date
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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