SEC Form 4 · accession 0001225208-15-021453

FULLER H B CO · FUL

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

James R Giertz

Officer — Executive VP and CFO

Period of report

Nov 5, 2015

Accepted (ET)

Nov 25, 2015 · 4:46 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000039368

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Nov 5, 2015	G	180	$0.00	D	78,352	D
Common Stock^F2,F3	Nov 5, 2015	G	285	$0.00	D	78,067	D
Common Stock^F4	holding	—	—		—	1,161	I	By 401(k) Plan

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Employee Stock Option (Right-to-Buy)^F5	$22.27	holding	—	—	—	—	Jan 20, 2021	Common Stock	28,768	28,768	D
Employee Stock Option (Right-to-Buy)^F6	$41.00	holding	—	—	—	—	Jan 22, 2025	Common Stock	28,486	28,486	D
Employee Stock Option (Right-to-Buy)^F7	$48.92	holding	—	—	—	—	Jan 23, 2024	Common Stock	22,886	22,886	D
Employee Stock Option (Right-to-Buy)^F8	$39.64	holding	—	—	—	—	Jan 24, 2023	Common Stock	22,455	22,455	D
Employee Stock Option (Right-to-Buy)^F5	$28.40	holding	—	—	—	—	Jan 26, 2022	Common Stock	28,556	28,556	D
Employee Stock Option (Right-to-Buy)^F5	$14.15	holding	—	—	—	—	Dec 4, 2018	Common Stock	47,663	47,663	D
Restricted Stock Units^F11,F9,F10	$0.00	holding	—	—	—	—	Jan 22, 2018	Common Stock	7,366	7,366	D
Restricted Stock Units^F11,F9,F12	$0.00	holding	—	—	—	—	Jan 23, 2017	Common Stock	4,618	4,618	D

Explanation of responses

F1Shares gifted by reportable person to Concordia University on November 5, 2015.
F10H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on January 22, 2016.
F11H.B. Fuller Company 2013 Master Incentive Plan: These restricted units include stock units acquired pursuant to a dividend equivalent reinvestment feature of H.B. Fuller Company's Amended and Restated Year 2000 Stock Incentive Plan.
F12H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on January 23, 2015.
F2Shares gifted by reportable person to Jr. Achievement of Upper Midwest on November 5, 2015.
F3Amended and Restated Year 2000 Stock Incentive Plan: 62,168 restricted shares were awarded pursuant to H.B. Fuller Company's Amended and Restated Year 2000 Stock Incentive Plan. This amount includes 6,002 restricted shares that vested effective April 2, 2011; 10,974 restricted shares that vested effective December 4, 2011; 13,202 restricted shares that vested in three equal annual installments beginning on December 3, 2010; 11,882 restricted shares that vested in three equal annual installments beginning on January 20, 2012; 11,540 restricted shares that vested in three equal annual installments beginning on January 26, 2013; and 8,568 shares that will vest in three equal annual installments beginning on January 24, 2014. Total amount also includes restricted shares acquired pursuant to a dividend accrual feature of the Amended and Restated Year 2000 Stock Incentive Plan.
F4401(k) Plan: This amount includes shares and dividends acquired pursuant to the H.B.Fuller Company 401(k) & Retirement Plan.
F5Amended and Restated Year 2000 Stock Incentive Plan: This option is 100% vested.
F6H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal annual installments beginning on January 22, 2016.
F7H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal annual installments beginning on January 23, 2015.
F8Amended and Restated Year 2000 Stock Incentive Plan: This option vests in three equal annual installments beginning on January 24, 2014.
F9H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units convert into shares of common stock on a 1-for-1 basis.