SEC Form 4 · accession 0001339595-16-000006
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas St Dennis
Director
Period of report
May 2, 2016
Accepted (ET)
May 3, 2016 · 7:08 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 2, 2016 | M | 116,600 | $0.00 | A | 144,720 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance SharesF1,F2 | $0.00 | May 2, 2016 | M | 116,600 | D | — | — | Common Stock | 116,600 | 0 | D |
Explanation of responses
- F1Represents the amount of performance-based restricted stock units (granted in May 2014) that were determined to be earned based on TSR for the two-year performance period ended March 31, 2016, as previously reported on a Form 4. These units are fully vested, and the underlying shares were released on May 2, 2016.
- F2The 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.