SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Jones Stacey

(Last) (First) (Middle)
C/O DESTINATION XL GROUP, INC.
555 TURNPIKE STREET

(Street)
CANTON MA 02021

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/21/2021
3. Issuer Name and Ticker or Trading Symbol
DESTINATION XL GROUP, INC. [ DXLG ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Human Resources Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, $0.01 par value 55,346 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Options (Right to Buy) 05/28/2014 05/28/2023 Common Stock 16,304 5.04 D
Non-Qualified Stock Options (Right to Buy) 06/11/2021 06/11/2030 Common Stock 81,788(1) 0.53 D
Restricted Stock Units 04/01/2021 10/24/2028 Common Stock 9,631(2) 0(4) D
Restricted Stock Units 04/01/2021 08/07/2029 Common Stock 12,674(3) 0(4) D
Explanation of Responses:
1. The non-qualified stock options ("Stock Options") represents the time-based portion of the 2020-2022 Long-Term Incentive Plan award to the Reporting Person. The Stock Options vest in four equal installments on June 11, 2021, April 1, 2022, April 1, 2023 and April 1, 2024. 20,447 options become exercisable on June 11, 2021.
2. The restricted stock units ("RSUs") represent the time-based portion of the 2018-2020 Long-Term Incentive Plan award to the Reporting Person. The RSUs vest in two equal installments on April 1, 2021 and April 1, 2022. 4,815 RSUs will vest on April 1, 2021.
3. The RSUs represent the time-based portion of the 2019-2021 Long-Term Incentive Plan award to the Reporting Person. The RSUs vest in three equal installments on April 1, 2021, April 1, 2022 and April 1, 2023. 4,225 RSUs will vest on April 1, 2021.
4. Each RSU, as defined in the Company's 2016 Incentive Compensation Plan, represents a contingent right to receive one share of DXLG common stock.
Stacey Jones 02/22/2021
** 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 5 (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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