SEC Form 4 · accession 0001225208-17-001500
FULLER H B CO · FUL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Patrick M. Kivits
Officer — Senior VP, EIMEA
Period of report
Jan 19, 2017
Accepted (ET)
Jan 23, 2017 · 7:25 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 | Jan 19, 2017 | M | 1,089 | $47.97 | A | 1,703 | D | |
| Common Stock | Jan 19, 2017 | M | 854 | $47.97 | A | 2,557 | D | |
| Common StockF1 | Jan 19, 2017 | F | 445 | $47.97 | D | 2,112 | D | |
| Common StockF2 | Jan 19, 2017 | F | 567 | $47.97 | D | 1,545 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Stock UnitsF4,F6,F3,F5 | $0.00 | Jan 19, 2017 | M | 1,089 | D | Jan 19, 2017 | Jan 19, 2019 | Common Stock | 1,089 | 1,737 | D |
| Restricted Stock UnitsF9,F7,F8 | $0.00 | Jan 19, 2017 | M | 854 | D | — | Jan 19, 2019 | Common Stock | 854 | 1,738 | D |
| Employee Stock Option (Right-to-Buy)F10 | $33.38 | holding | — | — | — | — | Jan 19, 2026 | Common Stock | 22,374 | 22,374 | D |
| Employee Stock Option (Right-to-Buy)F11 | $34.43 | holding | — | — | — | — | Oct 1, 2025 | Common Stock | 7,207 | 7,207 | D |
| Restricted Stock UnitsF9,F7,F12 | $0.00 | holding | — | — | — | — | Oct 1, 2018 | Common Stock | 1,254 | 1,254 | D |
Explanation of responses
- F1Shares withheld for taxes due on 854 shares issued pursuant to the H.B. Fuller Company 2013 Master Stock Incentive Plan.
- F10H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal installments beginning on January 19, 2017. This option makes up part of the reporting person's fiscal year 2016 long-term incentive plan grant.
- F11H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal annual installments beginning on October 1, 2016.
- F12H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on October 1, 2016.
- F2Shares withheld for taxes due on 1,089 shares issued pursuant to the H.B. Fuller Company 2013 Master Stock Incentive Plan.
- F3H.B. Fuller Company 2013 Master Incentive Plan: These performance stock units convert into shares of common stock on a 1-for-1 basis.
- F4This amount reflects a 127.5% payout based on the performance criteria achieved.
- F5H.B. Fuller Company 2013 Master Incentive Plan: These performance stock units vest in three annual installments beginning on the date shown upon H.B. Fuller achieving return on invested capital at least at the threshold level of performance in each year of the three years of vesting. These performance stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant.
- F6H.B. Fuller Company 2013 Master Incentive Plan: This amount has been adjusted to reflect the increase in number of performance stock units of the original grant based on performance criteria. Amount also includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature of the H.B. Fuller Company 2013 Master Incentive Plan.
- F7H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units convert into shares of common stock on a 1-for-1 basis.
- F8H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on January 19, 2017. These restricted stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant.
- F9H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units include stock units acquired pursuant to a dividend equivalent reinvestment feature of the H.B. Fuller Company 2013 Master Incentive Plan.