SEC Form 4/A · accession 0001225208-17-016635
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
James Owens
Officer — President and CEO
Period of report
Oct 20, 2017
Accepted (ET)
Oct 27, 2017 · 5:42 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 Option (Right-to-Buy)F1,F3,F2 | $57.70 | Oct 20, 2017 | A | 289,684 | A | Jan 31, 2021 | Oct 20, 2027 | Common Stock | 289,684 | 289,684 | D |
Explanation of responses
- F1Each performance-based non-qualified stock option represents a contingent right and option to purchase all or any part of an aggregate of 289,684 shares of Common Stock at the price of $57.70 per share. Prior to vesting, the number of options subject to the award will be adjusted based on the company's adjusted EBITDA performance for fiscal year 2020. The number of options may decrease to as low as 0% of the initial number of options depending on the level of adjusted EBITDA performance. The grant amount is shown at the superior level of performance. In no event will the maximum number of options granted exceed 289,684.
- F2These performance-based non-qualified stock options vest on the date shown contingent upon H.B. Fuller achieving adjusted EBITDA at least at the threshold level of performance.
- F3The insider did not pay any consideration for this option.
Remarks
In the reporting person's original Form 4 filing, the maximum number of performance-based non-qualified stock options to be earned were incorrectly reported.