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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GALLAGHER GERALD R 4912 MERILANE EDINA, MN 55436 |
See Remarks |
Gerald R. Gallagher | 07/14/2009 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | On July 10, 2009, Gerald R. Gallagher transferred 77,065 shares of the Issuer's Common Stock to Oak Investment Partners VII, LP ("Oak VII, LP") and 1,935 shares of the Issuer's Common Stock to Oak VII Affiliates Fund, LP ("Oak VII Affiliates, LP") without any additional consideration. Subsequently, Oak VII, LP and Oak VII Affiliates, LP sold the shares in open market transactions. Mr. Gallagher disclaims beneficial ownership of the shares held by the transferees, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the shares held by the transferees for purposes of Section 16 or for any other purpose. |
Remarks: Remarks: Gerald R. Gallagher was a Director of Ulta Salon, Cosmetics & Fragrances, Inc. Mr. Gallagher's term officially expired on June 17, 2009, re-election was not sought. Accordingly, Mr. Gallagher is no longer subject to the reporting requirements of Section 16 with respect to this Issuer, except as set forth in Rule 16a-2(b). |