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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
LYALL JONATHAN WADE

(Last) (First) (Middle)
C/O SKYLINE CHAMPION CORPORATION
2520 BY-PASS ROAD

(Street)
ELKHART IN 46514

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/30/2019
3. Issuer Name and Ticker or Trading Symbol
Skyline Champion Corp [ SKY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Vice President
5. If Amendment, Date of Original Filed (Month/Day/Year)
08/02/2019
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 45,579(1)(2) 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
Explanation of Responses:
1. This Amendment is being filed to correct an overstatement of the Reporting Person's Common Stock holdings by 8,260 shares on line 1 of his original Form 3 filed on August 2, 2019. The Reporting Person's Common Stock holdings were also overstated by 8,260 shares in the Form 4 filed by him on August 2, 2019.
2. The Reporting Person holds 36,122 shares of Common Stock that, subject to his continuous employment with the Issuer, vest at 50% per year on each of the first and second anniversaries of a secondary offering of the Issuer's shares. The unvested shares of Common Stock described in the immediately preceding sentence will vest in full upon a change of control of the Issuer, subject to the Reporting Person's continuous employment with the Issuer through the change in control date.
Remarks:
/s/ Caren A. Ries, Attorney-in-Fact 08/09/2019
** 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.
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.