# EDGAR Filing Document

**Accession Number:** 0001552800
**File Stem:** 0001104659-23-030200
**Filing Date:** 2023-3
**Character Count:** 8873
**Document Hash:** 7219bbb2c64e057c7e936db2e6a4c5e4
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001104659-23-030200.hdr.sgml**: 20230308

**ACCESSION NUMBER**: 0001104659-23-030200

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230306

**FILED AS OF DATE**: 20230308

**DATE AS OF CHANGE**: 20230308

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Lolmaugh Cabell
- **CENTRAL INDEX KEY:** 0001731797

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-35629
- **FILM NUMBER:** 23717708

**MAIL ADDRESS:**
- **STREET 1:** C/O 14000 CARLSON PARKWAY
- **CITY:** PLYMOUTH
- **STATE:** MN
- **ZIP:** 55441
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** TILE SHOP HOLDINGS, INC.
- **CENTRAL INDEX KEY:** 0001552800
- **STANDARD INDUSTRIAL CLASSIFICATION:** RETAIL-HOME FURNITURE, FURNISHINGS & EQUIPMENT STORES [5700]
- **IRS NUMBER:** 455538095
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 14000 CARLSON PARKWAY
- **CITY:** PLYMOUTH
- **STATE:** MN
- **ZIP:** 55441
- **BUSINESS PHONE:** 763-852-2950

**MAIL ADDRESS:**
- **STREET 1:** 14000 CARLSON PARKWAY
- **CITY:** PLYMOUTH
- **STATE:** MN
- **ZIP:** 55441

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Lolmaugh Cabell<br><sub>(Last) (First) (Middle)</sub><br>C/O TILE SHOP HOLDINGS, INC.<br>14000 CARLSON PARKWAY<br><sub>(Street)</sub><br>PLYMOUTH, MN 55441<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-06 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>TILE SHOP HOLDINGS, INC. [ TTSH ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-03-06 |  | A |  | 18520<sup>(1)</sup> | A | $0 | 205272 | D |  |
| Common Stock | 2023-03-06 |  | A |  | 37039<sup>(2)</sup> | A | $0 | 242311 | D |  |
| Common Stock | 2023-03-07 |  | F |  | 1845<sup>(3)</sup> | D | $4.94 | 240466<sup>(4)(5)</sup> | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Stock Option (Right to Buy) | $8.5 |  |  |  |  |  |  | <sup>(6)</sup> | 2027-11-06 | Common Stock | 26900 |  | 26900 | D |  |
| Stock Option (Right to Buy) | $5.55 |  |  |  |  |  |  | <sup>(6)</sup> | 2028-02-22 | Common Stock | 56000 |  | 56000 | D |  |
| Stock Option (Right to Buy) | $6.26 |  |  |  |  |  |  | <sup>(6)</sup> | 2029-02-20 | Common Stock | 97067 |  | 97067 | D |  |

---

### Footnotes:

(1) Represents shares of restricted stock for which the risks of forfeiture will lapse in three equal annual installments on each of 3/6/24, 3/6/25 and 3/6/26, subject to continuous employment as of the applicable vesting date.

(2) Represents shares of performance-based restricted stock for which the risks of forfeiture will lapse as to 30% of the shares on the date the Issuer files its annual report for the year ending December 31, 2023, 30% of the shares on the date the Issuer files its annual report for the year ending December 31, 2024, and 40% of the shares on the date the Issuer files its annual report for the year ending December 31, 2025, subject to (i) Mr. Lolmaugh remaining in continuous employment with the Issuer through December 31 of the year preceding the applicable vesting date and (ii) the Issuer achieving 15%, 20%, and 20% of adjusted pre-tax return on capital employed (as such results are reported in the Issuer's annual report for the applicable year) for each respective year.

(3) The reporting person has elected to satisfy his tax withholding obligation in connection with the vesting of a prior restricted stock grant by directing the Issuer to withhold shares otherwise issuable upon vesting of the previously reported grant.

(4) Includes (i) 56,988 shares of restricted stock for which the risks of forfeiture will lapse as to 28,494 shares on each of 3/16/23 and 3/16/24; (ii) 10,147 shares of restricted stock for which the risks of forfeiture will lapse as to 5,066 shares on 3/15/23 and 5,081 shares on 3/15/24; (iii) 10,274 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/7/24 and 3/7/25; (iv) 18,520 shares of restricted stock for which the risks of forfeiture will lapse in equal annual installments on each of 3/6/24, 3/6/25 and 3/6/26; and

(5) (v) the following shares of performance-based restricted stock, which are, in each case, subject to Mr. Lolmaugh remaining in continuous employment with the Issuer through December 31 of the year preceding the applicable vesting date and the Issuer achieving its performance target for each respective year: (A) 12,171 shares for which the risks of forfeiture will lapse on the date the Issuer files its annual report for the 2023 fiscal year; (B) 21,576 shares for which the risks of forfeiture will lapse as to 30% and 40% of the initial number of shares granted on each of the dates the Issuer files its annual report for the 2023 and 2024 fiscal years, respectively; and (C) 37,039 shares for which the risks of forfeiture will lapse as to 30%, 30% and 40% on each of the dates the Issuer files its annual report for the 2023, 2024 and 2025 fiscal years, respectively. The Issuer's proxy statement contains additional information regarding the applicable performance targets.

(6) Fully exercisable.

**Signature:** /s/ Cabell Lolmaugh  
**Date:** 2023-03-08

### Remarks:

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.

**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.**