SEC Form 4 · accession 0000899243-17-015800
Fortive Corp · FTV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mitchell P Rales
Director
Period of report
Jun 6, 2017
Accepted (ET)
Jun 8, 2017 · 5:00 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001659166
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.01F1 | Jun 6, 2017 | A | 2,800 | $0.00 | A | 3,987,853 | D | |
| Common Stock, par value $0.01F2 | holding | — | — | — | 14,500,000 | I | Through single-member LLCs | |
| Common Stock, par value $0.01F3 | holding | — | — | — | 327,587 | I | Through the Mitchell P. Rales Family Trust | |
| Common Stock, par value $0.01 | holding | — | — | — | 68,388 | I | By 401(k) | |
| Common Stock, par value $0.01F4 | holding | — | — | — | 12,585 | I | By spouse |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents restricted stock units granted on June 6, 2017 and payable solely in common stock. The restricted stock units granted will vest at the earlier of June 6, 2018 or the date of the Issuer's 2018 annual meeting, but the underlying shares will not be issued until the earlier of the Reporting Person's death or the first day of the seventh month following the Reporting Person's retirement from the Board of Directors of the Issuer.
- F2The reported shares are held through the following single-member LLCs: MPRDHR LLC, MPRDHR II LLC, MPRDHR III LLC, MPRDHR IV LLC and MPRDHR V LLC. The Reporting Person is the sole member of each of these LLCs.
- F3The Reporting Person is the trustee of the Mitchell P. Rales Family Trust. The Reporting Person disclaims beneficial ownership of the shares held by the Mitchell P. Rales Family Trust, except to the extent of the Reporting Person's pecuniary interest.
- F4The Reporting Person disclaims beneficial ownership of the shares held by his spouse, Emily W. Rales, and this report should not be deemed an admission that the Reporting Person is the beneficial owner of his spouse's shares for purposes of Section 16 or for any other purposes.