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*
Keane Robert S

(Last) (First) (Middle)
CIMPRESS,
275 WYMAN STREET

(Street)
WALTHAM MA 02451

(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)
Director 10% Owner
X Officer (give title below) X Other (specify below)
CEO, President / Chairman of Management Board
3. Date of Earliest Transaction (Month/Day/Year)
05/01/2018
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 05/01/2018 M(1)(2) 166,659 A $34.87 446,982(3) I By The Eastern Irrevocable Trust
Ordinary Shares 05/01/2018 F(1) 96,212(4) D $142.47 350,770(3) I By The Eastern Irrevocable Trust
Ordinary Shares 05/01/2018 M(1)(2) 166,659 A $34.87 446,942(3) I By The Western Irrevocable Trust
Ordinary Shares 05/01/2018 F(1) 96,212(4) D $142.47 350,730(3) I By The Western Irrevocable Trust
Ordinary Shares 46,375 I By RHS Holdings Incorporated
Ordinary Shares 51,900 I By Delaware 2001 Investment Trust
Ordinary Shares 390,000 I By First Delaware 2003 Investment Trust
Ordinary Shares 390,000 I By Second Delaware 2003 Investment Trust
Ordinary Shares 185,000 I By Third Delaware 2011 Investment Trust
Ordinary Shares 91,181 I By The Keane Family Foundation
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
Option (right to buy) $34.87 05/01/2018 M(1)(2) 166,659 05/02/2009(5) 05/02/2018 Ordinary Shares 166,659 $0.00 0 I By The Eastern Irrevocable Trust
Option (right to buy) $34.87 05/01/2018 M(1)(2) 166,659 05/02/2009(5) 05/02/2018 Ordinary Shares 166,659 $0.00 0 I By The Western Irrevocable Trust
Explanation of Responses:
1. This transaction was effected pursuant to a 10b5-1 trading plan adopted by the reporting person on November 27, 2017.
2. Option exercised in full due to expiration on May 2, 2018.
3. Includes 46,375 shares held by RHS Holdings Incorporated, of which The Eastern Irrevocable Trust and The Western Irrevocable Trust are the sole shareholders.
4. Of the 96,212 shares forfeited, 40,790 shares were forfeited as payment of the exercise price and 55,422 shares were forfeited as payment of the withholding taxes.
5. This option became exercisable as to 25% of the original number of shares on the Exercisable Date shown on Table II, and as to an additional 6.25% of the original number of shares at the end of each successive three-month period thereafter.
Remarks:
/s/Kathryn L. Leach, as attorney-in-fact for Robert S. Keane 05/03/2017
** 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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