SEC Form 4 · accession 0001590177-15-000015
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mike Slessor
Officer — CEO · Director
Period of report
Nov 6, 2015
Accepted (ET)
Nov 9, 2015 · 4:52 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 | Nov 6, 2015 | M | 19,998 | $0.00 | A | 208,616 | D | |
| Common StockF2,F3 | Nov 6, 2015 | S | 10,883 | $8.524 | D | 197,733 | 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 UnitsF4,F5 | $0.00 | Nov 6, 2015 | M | 19,998 | D | — | — | Common Stock | 19,998 | 0 | D |
Explanation of responses
- F1Represents vested shares of common stock issued pursuant to the conversion of one-third of the restricted stock units granted November 6, 2012.
- F2Represents vested shares of common stock sold to satisfy certain tax withholding obligations associated with the conversion of the restricted stock units.
- F3Price represents the weighted average sale price for the transaction reported. Price range of shares sold is $8.52 through $8.652. Reporting person undertakes to provide upon request by the SEC staff or a security holder of the Issuer, full information regarding the number of shares sold at each separate price.
- F4The Restricted Stock Units vest and are exercisable in three annual installments on each November 6 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).
- F5The restricted stock units released were settled in shares of common stock and were immediately cancelled upon settlement.
Remarks
EXHIBIT LIST: EX-24 POA - Slessor