5: Annual statement of changes in beneficial ownership of securities
Published on February 8, 2021
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN 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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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 2270 (9-02) |
(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 Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owners
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Nordhagen Arlen Dale C/O NATIONAL STORAGE AFFILIATES TRUST 8400 EAST PRENTICE AVENUE, 9TH FLOOR GREENWOOD VILLAGE, CO 80111 |
X | Executive Chairman |
Signatures
Arlen Dale Nordhagen, by Jason Parsont, his Attorney-in-fact | 02/08/2021 | |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | 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) | Reflects the transfer of common shares of beneficial interest of National Storage Affiliates Trust ("Shares") as a bona fide gift to nonprofit tax-exempt organizations under section 501(c)(3) of the internal revenue code ("501(c)(3) charitable organizations"). |
(2) | Excludes 106,119 Shares that the Reporting Person contributed to SecurCare Bonus Pool, LLC ("Bonus Pool") on March 31, 2020, as previously reported on the Reporting Person's Form 4 dated April 1, 2020. On October 17, 2020, the Reporting Person resigned as a manager of Bonus Pool and is no longer a controlling person of Bonus Pool and does not have or share voting or investment power over the portfolio of Bonus Pool. |
(3) | Reflects the transfer of Shares as a bona fide gift to an irrevocable charitable trust. |
(4) | Reflects the transfer of Shares as a bona fide gift to an irrevocable family trust. |
(5) | The Reporting Person's total direct and indirect ownership of Shares following the transactions reported in the table above is 4,226,851 Shares, which includes those Shares previously reported. The 4,226,851 Shares do not include derivative securities of the Reporting Person that have been reported on the Reporting Person's Forms 3 and Forms 4. Of those 4,226,851 Shares previously reported and reported herein, 170,000 Shares held directly by the Reporting Person were transferred on December 24, 2020 to Nordhagen LLLP, an entity in which the Reporting Person has or shares voting and/or investment power, in a transaction that effects only a change in the form of beneficial ownership without changing the Reporting Person's pecuniary interest in such Shares. |
(6) | This filing shall not be deemed to be an admission that the Reporting Person is the beneficial owner of any of the securities reported herein, and the Reporting Person disclaims beneficial ownership of such securities except to the extent of the Reporting Person's pecuniary interest therein. |