SEC Form 4 · accession 0001256951-15-000016
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas St Dennis
Officer — EXECUTIVE CHAIRMAN · Director
Period of report
May 5, 2015
Accepted (ET)
May 7, 2015 · 4:56 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 StockF1 | May 5, 2015 | M | 20,000 | $0.00 | A | 159,333 | D | |
| Common StockF2 | May 6, 2015 | S | 10,607 | $8.2511 | D | 148,726 | 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 | May 5, 2015 | M | 20,000 | D | — | — | Common Stock | 20,000 | 80,000 | D |
Explanation of responses
- F1Represents vested shares of common stock issued pursuant to the first conversion of the restricted stock units granted May 5, 2014.
- 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 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).
- F4The restricted stock units released were settled in shares of common stock and were immediately cancelled upon settlement.
Remarks
THE ATTACHED CONFIRMING STATEMENT GRANTING THE ATTORNEY-IN-FACT THE AUTHORITY TO EXECUTE AND FILE THIS FORM 4 HAS BEEN FILED WITH THE U.S. SECURITIES AND EXCHANGE COMMISSION.