SEC Form 4 · accession 0001628280-16-015403
FORMFACTOR INC · FORM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edward Rogas Jr.
Director
Period of report
May 2, 2016
Accepted (ET)
May 3, 2016 · 7:30 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 | 10,000 | $0.00 | A | 50,000 | 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 2, 2016 | M | 10,000 | D | — | — | Common Stock | 10,000 | 0 | D |
Explanation of responses
- F1Represents vested shares of common stock issued pursuant to the conversion of 100% of the restricted stock units granted on May 1, 2015.
- F2Restricted Stock Units vested and became exercisable in 12 equal monthly installments with the vesting dates beginning on June 1, 2015 and ending on May 1, 2016. Settlement of vested Units into common stock occurred on May 2, 2016.
- F3The restricted stock units released were settled in shares of common stock and were immediately cancelled upon settlement.
Remarks
EXHIBIT LIST: EX-24 POA - Rogas