Statement of Changes in Beneficial Ownership (4)
2016年11月19日 - 7:16AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
ROBINSON HARRIETT J
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2. Issuer Name
and
Ticker or Trading Symbol
GRAY TELEVISION INC
[
GTN
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
4370 PEACHTREE ROAD, NE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/16/2016
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(Street)
ATLANTA, GA 30319
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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109750
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I
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Trustee for Children
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Class A Common Stock
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1189180
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I
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Trustee for Children
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Common Stock
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35000
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I
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Delta Fire & Casualty Insurance Co.
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Class A Common Stock
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33750
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I
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Delta Fire & Casualty Insurance Co.
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Common Stock
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10000
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I
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Delta Life Insurance Co.
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Class A Common Stock
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135795
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I
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Delta Life Insurance Co.
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Class A Common Stock
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221706
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I
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Bankers Fidelity Life Insurance Co.
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Class A Common Stock
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658566
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I
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Atlantic American Corporation
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Common Stock
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56000
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I
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Atlantic American Corporation
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Common Stock
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50000
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I
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American Southern Insurance Co.
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Common Stock
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100000
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I
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Gulf Capital Services, Ltd.
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Class A Common Stock
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490298
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I
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Gulf Capital Services, Ltd.
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Class A Common Stock
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11/16/2016
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P
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6100
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A
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$9.55
(1)
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992753
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D
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Common Stock
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442236
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D
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Common Stock
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832500
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I
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Trustee for Grandchildren
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Class A Common Stock
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999000
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I
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Trustee for Grandchildren
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Explanation of Responses:
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(
1)
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The price reported in Column 4 is a weighted average price. The shares were purchased in multiple transactions at prices ranging from $9.187 to $10.040 per share, inclusive. The reporting person undertakes to provide to Gray Television, Inc., any security holder of Gray Television, Inc. or the staff of the Securities and Exchange Commission upon request, all information regarding the number of shares purchased at each separate price within the range set forth above.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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ROBINSON HARRIETT J
4370 PEACHTREE ROAD, NE
ATLANTA, GA 30319
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X
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X
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Signatures
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/s/ Dottie Boudreau by Power of Attorney
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11/18/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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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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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.
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