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
 
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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*
JORDAN MARK S

(Last) (First) (Middle)
3525 FAIRYSTONE PARK HWY
P O BOX 626

(Street)
BASSETT VA 24055

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
BASSETT FURNITURE INDUSTRIES INC [ BSET ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, Upholstery
3. Date of Earliest Transaction (Month/Day/Year)
04/03/2018
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
Common Stock 04/03/2018 M 3,400 A $8.02(1) 14,810 D
Common Stock 04/03/2018 S 3,400 D $30.0594(2) 11,410 D
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
Option(3) $8.02 04/03/2018 M 500 07/13/2012 07/12/2021 Common Stock 500 $8.02 0 D
Option(3) $8.02 04/03/2018 M 2,000 07/13/2013 07/12/2021 Common Stock 2,000 $8.02 0 D
Option(3) $8.02 04/03/2018 M 900 07/13/2014 07/12/2021 Common Stock 900 $8.02 1,100 D
Option(3) $8.02 07/13/2015 07/12/2021 Common Stock 2,000 2,000 D
Explanation of Responses:
1. Corresponds to the exercise price of the stock options.
2. Price is a weighted average of multiple trades ranging from $30.00 to $30.30 and reporting person undertakes to provide upon request to SEC staff, the issuer or security holder of the issuer, full information regarding the number of shares and prices at which the transaction was effected.
3. Granted under the 2010 Employee Stock Plan which is a Rule 16b-3 Plan.
/s/ Mark S. Jordan 04/04/2018
** 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.
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