SEC FORM 3/A 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*
Valle Edward

(Last) (First) (Middle)
C/O EL POLLO LOCO HOLDINGS, INC.
3535 HARBOR BLVD., SUITE 100

(Street)
COSTA MESA CA 92626

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/24/2014
3. Issuer Name and Ticker or Trading Symbol
El Pollo Loco Holdings, Inc. [ LOCO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Marketing Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
07/24/2014
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)
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
Stock Options (right to buy) (1) 04/17/2022 Common Stock 149,866 2.63 D
Stock Options (right to buy) (2) 04/17/2022 Common Stock 299,733 5.84 D
Explanation of Responses:
1. The Stock Options were granted under the Corporation's 2012 Stock Option Plan with 112,400 options fully vested and 18,733 options vesting on December 31, 2014 and April 17, 2015, in certain cases subject to the satisfaction of certain performance conditions.
2. The Stock Options were granted under the Corporation's 2012 Stock Option Plan with 224,800 options fully vested and 37,466 options vesting on December 31, 2014 and April 17, 2015, in certain cases subject to the satisfaction of certain performance conditions.
Remarks:
This Statement on this Form is being amended to correct an administrative error and to reflect, for certain previously unadjusted line items, the effects of the Issuer's stock split of 8.56381:1 of July 14, 2014, which was effective prior to the original filing of this Statement. This amendment brings this Statement into alignment with the information presented in the Issuer's prospectus of July 24, 2014.
/s/ Edith R. Austin, as attorney-in-fact 08/21/2014
** 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.