SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Christensen McCord

(Last) (First) (Middle)
923 S. BRIDGEWAY PLACE

(Street)
EAGLE ID 83616

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PetIQ, Inc. [ PETQ ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
03/13/2019
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Unit (1) 03/13/2019 A 8,114 (2) (2) Class A Common Stock 8,114 $0 8,114 D
Option to Purchase Class A Common Stock $27.73 03/13/2019 A 37,865 03/13/2020(3) 03/13/2029 Class A Common Stock 37,865 $0 37,865 D
Explanation of Responses:
1. Each Restricted Stock Units ("RSU") represents a contingent right to receive one share of Class A Common Stock.
2. The RSU's vest in approximately equal installments on each of the first four anniversaries of March 13, 2019, subject to the reporting person's continuous service as an employee of the Issuer.
3. The options vest in approximately equal installments on each of the first four anniversaries of March 13, 2019, subject to the reporting person's continuous service as an employee of the Issuer.
/s/ R. Michael Herrman, Attorney in Fact 03/15/2019
** 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 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.
                               POWER OF ATTORNEY
                              (SECTION 16 FILINGS)

      Know  all  by  these  presents that the undersigned hereby constitutes and
appoints  each  of  R.  Michael Herrman, John Newland and Patrick Jones, signing
singly, the undersigned's true and lawful attorney-in-fact to:

   1. Execute  for  and  on  behalf  of  the  undersigned,  in the undersigned's
      capacity as an officer, director or greater than 10% shareholder of PetIQ,
      Inc.  ("PetIQ"),  Forms 3, 4 and 5 in accordance with Section 16(a) of the
      Securities  Exchange Act of 1934 and the rules and regulations promulgated
      thereunder;

   2. Do and perform any and all acts for and on behalf of the undersigned which
      may  be  necessary or desirable to complete and execute any such Form 3, 4
      or  5, complete and execute any amendment or amendments thereto and timely
      file  such  form with the United States Securities and Exchange Commission
      and  any  national  quotation  system, national securities exchange, stock
      exchange or similar authority; and

   3. Take  any  other  action  of  any  type  whatsoever in connection with the
      foregoing  which,  in  the  opinion  of  such  attorney-in-fact, may be of
      benefit   to,  in  the  best  interest  of  or  legally  required  by  the
      undersigned,  it  being  understood  that  the  documents executed by such
      attorney-in-fact  on  behalf  of the undersigned pursuant to this Power of
      Attorney shall be in such form and shall contain such terms and conditions
      as   such   attorney-in-fact   may   approve  in  such  attorney-in-fact's
      discretion.

      The  undersigned  hereby  grants  to  such attorney-in-fact full power and
authority  to  do  and perform any and every act and thing whatsoever requisite,
necessary  or  proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could  do  if personally present, with full power of substitution or revocation,
hereby  ratifying  and  confirming  all  that  such  attorney-in-fact,  or  such
attorney-in-fact's  substitute  or substitutes, shall lawfully do or cause to be
done  by  virtue  of  this  Power  of  Attorney and the rights and powers herein
granted.  The  undersigned  acknowledges that the foregoing attorney-in-fact, in
serving in such capacity at the request of the undersigned, is not assuming, nor
is  PetIQ  assuming,  any  of  the undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934.

      This  Power  of  Attorney  shall remain in full force and effect until the
undersigned  is  no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued by PetIQ, unless
earlier  revoked  by  the  undersigned  in  a  signed  writing  delivered to the
foregoing attorney-in-fact.

      IN  WITNESS  WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of this 5th day of March, 2019

                                                          /s/ McCord Christensen
                                                        ------------------------
                                                        Name: McCord Christensen