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Grubbs Michael DFORM 3UNITED 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 1940OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response:
0.5OMB APPROVALOMB Number:
3235-0104
Estimated average burden
hours per response:
0.5OMB Number:3235-0104Estimated average burdenhours per response:1. Name and Address of Reporting Person*GRUBBS MICHAEL D
(Last)
(First)
(Middle)
C/O TRI POINTE HOMES, INC.
19520 JAMBOREE ROAD, SUITE 200
(Street)
IRVINE
CA
92612
(City)
(State)
(Zip)GRUBBS MICHAEL D(Last)(First)(Middle)C/O TRI POINTE HOMES, INC.19520 JAMBOREE ROAD, SUITE 200IRVINECA(City)(State)(Zip)2. Date of Event Requiring Statement
(Month/Day/Year)
01/30/20133. Issuer Name and Ticker or Trading Symbol
TRI Pointe Homes, Inc.
[ TPH ]4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director
10% Owner
X
Officer (give title below)
Other (specify below)
See RemarksDirector10% OwnerXOfficer (give title below)Other (specify below)See Remarks5. 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 PersonForm filed by One Reporting PersonForm filed by More than One Reporting PersonTable I - Non-Derivative Securities Beneficially Owned1. 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 Stock795,383(1)D42,381(1)IBy The Grubbs Family Trust48,427(1)By BMG Homes, Inc.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 Security5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)6. Nature of Indirect Beneficial Ownership (Instr.
5)Date ExercisableExpiration DateTitleAmount or Number of SharesExplanation of Responses:1. The actual number of shares of common stock owned is subject to adjustment following the completion of the initial public offering (the "IPO") of TRI Pointe Homes, Inc. (the "Issuer") based upon the average closing price of the shares of common stock of the Issuer on the New York Stock Exchange for the ten trading days following the IPO.Remarks:CHIEF FINANCIAL OFFICER AND TREASURER/s/ Michael D. Grubbs01/30/2013** Signature of Reporting PersonDateReminder: 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.PK ! pz docProps/app.xml
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