SEC Form 4/A · accession 0001225208-17-013993
FULLER H B CO · FUL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Zhiwei Cai
Officer — Sr. VP, Engineering Adhesives
Period of report
Feb 10, 2017
Accepted (ET)
Aug 15, 2017 · 12:06 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000039368
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Stock UnitsF2,F4,F1,F3 | $0.00 | Feb 12, 2017 | M | 320 | D | Feb 12, 2017 | Feb 12, 2019 | Common Stock | 320 | 515 | D |
Explanation of responses
- F1H.B. Fuller Company 2013 Master Incentive Plan: These performance stock units convert into shares of common stock on a 1-for-1 basis.
- F2This amount reflects a 127.5% payout based on the performance criteria achieved.
- F3H.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.
- F4This 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.
Remarks
Amendment filed to correct Performance Stock Unit balance on Table II after vesting on February 12, 2017. Adjustment for 127.5% performance criteria (as noted in footnote 9) was inadvertently missed.