SEC Form 5 · accession 0001659166-17-000016
Fortive Corp · FTV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan L Schwarz
Officer — VP - Corporate Development
Period of report
Dec 31, 2016
Accepted (ET)
Jan 4, 2017 · 8:12 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001659166
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Executive Deferred Incentive Program - Fortive Stock FundF1,F2,F3 | $0.00 | Sep 30, 2016 | A | 1 | A | — | — | Common Stock | 1 | 871 | D |
| Executive Deferred Incentive Program - Fortive Stock FundF1,F2,F3 | $0.00 | Dec 30, 2016 | A | 1 | A | — | — | Common Stock | 1 | 871 | D |
Explanation of responses
- F1The reported securities are notional dividend accruals on phantom shares in the Fortive stock fund (the "EDIP Stock Fund") under Fortive's Executive Deferred Incentive Program (the "EDIP"). The number of phantom shares accrued as a result of such notional dividend accruals is based on the closing price of the Issuer's common stock as reported on the NYSE on the date such dividend accruals are credited to the EDIP Stock Fund, which is the price shown in Table II, Column 8 above.
- F2The notional shares convert on a one-to-one basis.
- F3The Reporting Person immediately vests in 100% of each voluntary contribution to the EDIP Stock Fund. The Reporting Person will vest in all contributions to the EDIP Stock Fund by the Issuer as follows: 100% upon the earlier of the Reporting Person's death, or upon retirement following at least 5 years of service with the Issuer and reaching the age of 55, or, if earlier, one-tenth per year of participation following five years of participation, in each case in accordance with the EDIP. Upon termination of employment, the vested portion of the EDIP Stock Fund is settled in the Issuer's common stock.