SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Piper Michael

(Last) (First) (Middle)
1716 CORPORATE LANDING PKWY

(Street)
VIRGINIA BEACH VA 23454

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/15/2018
3. Issuer Name and Ticker or Trading Symbol
Liberty Tax, Inc. [ TAX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (2) (2) Class A Common Stock 32,203 (1) D
Employee Stock Options (Right to Buy) (3) (4) Class A Common Stock 175,000 8.85 D
Explanation of Responses:
1. Each Restricted Stock Unit represents the right to receive, at settlement, one share of Class A Common Stock.
2. Each year for three years starting June 15, 2019, one-third of the Restricted Stock Units shall become vested provided that the Employee is in the employ of the Company at the time of vesting.
3. Each year for three years beginning June 15, 2019, one-third of the Employee Stock Options shall become vested.
4. Once exercisable, Employee Stock Options that become vested anytime from the date of vesting through five years from the date of vesting shall remain exercisable, provided that the Employee is in the employ of the Company at the time of each vesting.
Michael Piper 06/18/2018
** 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 5 (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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