Statement of Changes in Beneficial Ownership (4)
07 Noviembre 2013 - 4:33PM
Edgar (US Regulatory)
FORM 4
[
X
]
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
*
GANGWAL RAKESH
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2. Issuer Name
and
Ticker or Trading Symbol
MAPLEBY HOLDINGS MERGER Corp
[
OMX
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
C/O OFFICEMAX INCORPORATED, 263 SHUMAN BLVD.
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/5/2013
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(Street)
NAPERVILLE, IL 60563
(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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11/5/2013
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D
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179363
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D
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(1)
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0
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D
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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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Purchase Option
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$2.21
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11/5/2013
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D
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665
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7/1/2000
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(2)
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Common Stock
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665
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(2)
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0
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D
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Purchase Option
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$2.21
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11/5/2013
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D
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906
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7/1/2001
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(3)
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Common Stock
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906
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(3)
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0
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D
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Purchase Option
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$2.21
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11/5/2013
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D
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52
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7/1/2002
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(4)
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Common Stock
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52
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(4)
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0
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D
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Purchase Option
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$2.21
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11/5/2013
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D
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2523
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7/1/2003
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(5)
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Common Stock
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2523
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(5)
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0
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D
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Purchase Option
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$2.21
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11/5/2013
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D
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1864
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7/1/2004
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(6)
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Common Stock
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1864
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(6)
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0
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D
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Purchase Option
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$2.21
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11/5/2013
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D
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1674
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7/1/2005
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(7)
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Common Stock
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1674
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(7)
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0
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D
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Explanation of Responses:
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(
1)
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Disposed of pursuant to a merger agreement between OfficeMax Incorporated (the "Company"), Office Depot, Inc. ("ODP") and their respective subsidiaries, in exchange for 2,919 restricted shares of ODP common stock and 479,568 ODP restricted stock units, on the effective date of the merger (such merger, the "Merger") (in accordance with the exchange ratio set forth in the merger agreement pursuant to which each share of the Company's common stock was exchanged for 2.69 shares of ODP common stock). The closing price of ODP common stock on November 5, 2013 (the effective date of the Merger) was $5.65 per share.
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(
2)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 1,788 shares of ODP common stock for $0.83 per share.
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(
3)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 2,437 shares of ODP common stock for $0.83 per share.
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(
4)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 139 shares of ODP common stock for $0.83 per share.
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(
5)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 6,786 shares of ODP common stock for $0.83 per share.
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(
6)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 5,014 shares of ODP common stock for $0.83 per share.
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(
7)
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This stock option, which provided for expiration three years after the reporting person's termination as a director of the Company, was assumed by ODP in connection with the Merger and replaced with an option to purchase 4,503 shares of ODP common stock for $0.83 per share.
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Remarks:
In connection with the Merger (defined in the footnotes above), Mapleby Holdings Merger Corporation has become the successor registrant to OfficeMax Incorporated.
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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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GANGWAL RAKESH
C/O OFFICEMAX INCORPORATED
263 SHUMAN BLVD.
NAPERVILLE, IL 60563
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X
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Signatures
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/s/ Matthew R. Broad, by POA from Rakesh Gangwal
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11/7/2013
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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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