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*
Jacobson Allen D.

(Last) (First) (Middle)
C/O LAWSON PRODUCTS, INC.
8770 WEST BRYN MAWR AVENUE, SUITE 900

(Street)
CHICAGO IL 60631

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/12/2015
3. Issuer Name and Ticker or Trading Symbol
LAWSON PRODUCTS INC/NEW/DE/ [ LAWS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Sales
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)
Common Stock 2,346 D
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
Stock Options(1) 12/31/2012 12/31/2020 Common Stock 1,434 14.04 D
Stock Performance Rights(2) 12/22/2012 12/22/2016 Common Stock 2,900 17.65 D
Stock Performance Rights(2) 12/31/2014 10/02/2017 Common Stock 5,000 10 D
Restricted Stock Award(3) 12/31/2014 10/02/2017 Common Stock 5,000 10 D
Stock Performance Rights(2) 12/31/2015 12/31/2020 Common Stock 4,398 12.18 D
Stock Performance Rights(2) 12/31/2016 12/31/2021 Common Stock 7,306 13.92 D
Stock Performance Rights(2) 12/31/2017 12/31/2022 Common Stock 2,704 25.16 D
Market Stock Units(4) 12/31/2015 12/31/2015 Common Stock 2,839 0.0 D
Market Stock Units(5) 12/31/2016 12/31/2016 Common Stock 5,390 0.0 D
Market Stock Units(6) 12/31/2017 12/31/2017 Common Stock 4,230 0.0 D
Explanation of Responses:
1. Represents the right to purchase one share of common stock in exchange for the exercise price of $14.04 at the date the reporting person exercises the right.
2. Represents the right to receive cash in an amount equal to the appreciation in the common stock above the exercise price at the date the reporting person exercises the right.
3. Represents the right to receive an amount of shares of common stock equal in value to the appreciation of the common stock from the $10.00 exercise price up to the date of exercise.
4. Represents the right to receive an amount of shares of common stock, up to the amount set forth in the table, based upon the appreciation of the common stock from the grant date to December 31, 2015.
5. Represents the right to receive an amount of shares of common stock, up to the amount set forth in the table, based upon the appreciation of the common stock from the grant date to December 31, 2016.
6. Represents the right to receive an amount of shares of common stock, up to the amount set forth in the table, based upon the appreciation of the common stock from the grant date to December 31, 2017.
Remarks:
/s/ Neil E. Jenkins, Attorney-in-Fact 05/13/2015
** 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 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.