SEC Form 4 · accession 0001256949-15-000004
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas St Dennis
Officer — CEO · Director
Period of report
Feb 10, 2015
Accepted (ET)
Feb 12, 2015 · 6:09 pm EST
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 StockF1 | Feb 10, 2015 | M | 16,667 | $0.00 | A | 127,015 | D | |
| Common StockF2 | Feb 11, 2015 | M | 6,846 | $8.5175 | D | 120,169 | 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 UnitsF3,F4 | $0.00 | Feb 10, 2015 | M | 16,667 | D | — | — | Common Stock | 16,667 | 105,000 | D |
Explanation of responses
- F1Represents vested shares of common stock issued pursuant to the conversion of one-third of the restricted stock units granted May 4, 2012.
- F2Represents vested shares of common stock sold to satisfy certain tax withholding obligations associated with the conversion of the restricted stock units.
- F3The Restricted Stock Units vest and are exercisable in three annual installments on each February 10 of 2013, 2014, and 2015 (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).
- F4The restricted stock units released were settled in shares of common stock and were immediately cancelled upon settlement.
Remarks
THE CONFIRMING STATEMENT GRANTING THE ATTORNEY-IN-FACT THE AUTHORITY TO EXECUTE AND FILE THIS FORM 4 HAS BEEN PREVIOUSLY FILED WITH THE U.S. SECURITIES AND EXCHANGE COMMISSION.