SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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: 3235-0362
Estimated average burden
hours per response: 1.0
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
SMITH DAVID D

(Last) (First) (Middle)
C/O SINCLAIR BROADCAST GROUP
10706 BEAVER DAM ROAD

(Street)
COCKEYSVILLE MD 21030

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SINCLAIR BROADCAST GROUP INC [ SBGI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Executive Chairman
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2019
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class B Common Stock $0 05/09/2019 G(1) 100,000 (2) (2) Class B Common Stock 100,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 05/09/2019 A(5) 100,000 (2) (2) Class B Common Stock 100,000 $0 100,000(3)(4) I By Irrevocable Trust 2019/BECS(6)
Class B Common Stock $0 05/09/2019 G(1) 200,000 (2) (2) Class B Common Stock 200,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 05/09/2019 A(5) 200,000 (2) (2) Class B Common Stock 200,000 $0 200,000(3)(4) I By Irrevocable Trust 2019/BECS II(6)
Class B Common Stock $0 05/09/2019 G(1) 100,000 (2) (2) Class B Common Stock 100,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 05/09/2019 A(5) 100,000 (2) (2) Class B Common Stock 100,000 $0 100,000(3)(4) I By Irrevocable Trust 2019/JBSS(6)
Class B Common Stock $0 05/09/2019 G(1) 100,000 (2) (2) Class B Common Stock 100,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 05/09/2019 A(5) 100,000 (2) (2) Class B Common Stock 100,000 $0 100,000(3)(4) I By Irrevocable Trust 2019/MJSS(6)
Class B Common Stock $0 05/09/2019 G(1) 100,000 (2) (2) Class B Common Stock 100,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 05/09/2019 A(5) 100,000 (2) (2) Class B Common Stock 100,000 $0 100,000(3)(4) I By Irrevocable Trust 2019/DBS(6)
Class B Common Stock $0 08/20/2019 G(1) 250,000 (2) (2) Class B Common Stock 250,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 08/20/2019 A(5) 250,000 (2) (2) Class B Common Stock 250,000 $0 250,000(3)(4) I By Irrevocable Trust II 2019/BECS(6)
Class B Common Stock $0 08/20/2019 G(1) 250,000 (2) (2) Class B Common Stock 250,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 08/20/2019 A(5) 250,000 (2) (2) Class B Common Stock 250,000 $0 250,000(3)(4) I By Irrevocable Trust II 2019/BECS II(6)
Class B Common Stock $0 08/20/2019 G(1) 250,000 (2) (2) Class B Common Stock 250,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 08/20/2019 A(5) 250,000 (2) (2) Class B Common Stock 250,000 $0 250,000(3)(4) I By Irrevocable Trust II 2019/JBSS(6)
Class B Common Stock $0 08/20/2019 G(1) 250,000 (2) (2) Class B Common Stock 250,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 08/20/2019 A(5) 250,000 (2) (2) Class B Common Stock 250,000 $0 250,000(3)(4) I By Irrevocable Trust II 2019/MJSS(6)
Class B Common Stock $0 08/20/2019 G(1) 250,000 (2) (2) Class B Common Stock 250,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 08/20/2019 A(5) 250,000 (2) (2) Class B Common Stock 250,000 $0 250,000(3)(4) I By Irrevocable Trust II 2019/DBS(6)
Class B Common Stock $0 11/08/2019 G(7) 40,000 (2) (2) Class B Common Stock 40,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 11/08/2019 G(8) 40,000 (2) (2) Class B Common Stock 40,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 11/08/2019 G(9) 40,000 (2) (2) Class B Common Stock 40,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 11/08/2019 G(10) 40,000 (2) (2) Class B Common Stock 40,000 $0 4,056,072.227(3)(4) D
Class B Common Stock $0 11/08/2019 G(11) 40,000 (2) (2) Class B Common Stock 40,000 $0 4,056,072.227(3)(4) D
Explanation of Responses:
1. Gifted to Trust f/b/o Reporting Person's family member
2. The Class B Common Stock is convertible at the Reporting Person's election and has no expiration date.
3. After giving effect to the transactions reported on this Form 5 and the transactions reported on the Form 5/A referenced in the Remarks section of this Form 5, the Reporting Person directly owns 4,056,072.227 shares of Class B Common Stock at the end of the issuer's fiscal year.
4. The Reporting Person also directly owns (i) 756,332 shares of Class A Common Stock, (ii) 11,809.667933 shares of Class A Common Stock held in a 401(k) unitized stock fund, and (iii) 134,172 shares of Class A Common Stock issued as Restricted Stock. The Reporting Person indirectly owns (i) 28,160 shares of Class A Common Stock held in separate custodial accounts established by the Reporting Person for the benefit of family members of which the Reporting Person is the custodian, (ii) 338,400 shares of Class A Common Stock held by trusts f/b/o family members of which the Reporting Person is a trustee, (iii) 162,553 shares of Class A Common Stock held by a limited liability company controlled by the Reporting Person, (iv) 654,000 shares of Class A Common Stock held f/b/o David D. Smith Foundation, Inc., which the Reporting Person controls but does not derive any benefit, and (v) 2,855,000 shares of Class B Common Stock held by trusts f/b/o family members.
5. Acquired by gift from Reporting Person.
6. The Reporting Person has the right to substitute the corpus of the trust.
7. Distribution of Class B Common Stock to the Reporting Person from independent trustee pursuant to the terms of the Irrevocable Trust Agreement/BECS dated August 15, 2018.
8. Distribution of Class B Common Stock to the Reporting Person from independent trustee pursuant to the terms of the Irrevocable Trust Agreement/BECS II dated August 15, 2018.
9. Distribution of Class B Common Stock to the Reporting Person from independent trustee pursuant to the terms of the Irrevocable Trust Agreement/JBSS dated August 15, 2018.
10. Distribution of Class B Common Stock to the Reporting Person from independent trustee pursuant to the terms of the Irrevocable Trust Agreement/MJSS dated August 15, 2018.
11. Distribution of Class B Common Stock to the Reporting Person from independent trustee pursuant to the terms of the Irrevocable Trust Agreement/DBS dated August 15, 2018.
Remarks:
This Form 5 filing is Part 1 of 2. Due to do the number of entry limitations allowed on one Form 5 filing, the additional entries will be filed on a Form 5/A.
Clinton R. Black, V, Esq., on behalf of David D. Smith, by Power of Attorney 02/12/2020
** 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.