SEC Form 4 · accession 0001039399-17-000021
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael M Ludwig
Officer — SR VP, CFO
Period of report
May 5, 2017
Accepted (ET)
May 9, 2017 · 6:31 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001039399
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | May 5, 2017 | M | 15,000 | $0.00 | A | 254,369 | D | |
| Common StockF1 | May 5, 2017 | F | 5,637 | $14.25 | D | 248,732 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF2,F3 | $0.00 | May 5, 2017 | M | 15,000 | D | — | — | Common Stock | 15,000 | 0 | D |
Explanation of responses
- F1Exempt transaction pursuant to Section 16b-3(e) - payment of exercise price or tax liability by delivering or withholding securities incident to the receipt, exercise or vesting of a security issued in accordance with Rule 16b-3. All of the shares reported as disposed of in this Form 4 were relinquished by the Reporting Person and cancelled by the Issuer in exchange for the Issuer's agreement to pay federal and state tax withholding obligations of the Reporting Person resulting from the vesting of RSUs. The Reporting Person did not sell or otherwise dispose of any of the shares for any reason other than to cover required taxes.
- F2The Restricted Stock Units vest and are exercisable in three annual installments on each May 5 of 2015, 2016, and 2017 (or the first market trading day during an open trading window under the Issuer's insider trading policy thereafter if the applicable vesting date is not on a market trading day during an open trading window).
- F3The restricted stock units released were settled in shares of common stock and were immediately cancelled upon settlement.