SEC Form 4 · accession 0001225208-18-001397
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, 2018
Accepted (ET)
Jan 23, 2018 · 5:37 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, 2018 | M | 1,015 | $54.83 | A | 1,358 | D | |
| Common Stock | Jan 19, 2018 | M | 865 | $54.83 | A | 2,223 | D | |
| Common StockF1 | Jan 19, 2018 | F | 450 | $54.83 | D | 1,773 | D | |
| Common StockF2 | Jan 19, 2018 | F | 529 | $54.83 | D | 1,244 | 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, 2018 | M | 1,015 | D | Jan 19, 2017 | Jan 19, 2019 | Common Stock | 1,015 | 888 | D |
| Restricted Stock UnitsF9,F7,F8 | $0.00 | Jan 19, 2018 | M | 865 | D | Jan 19, 2017 | Jan 19, 2019 | Common Stock | 865 | 892 | D |
| Employee Stock Option (Right-to-Buy)F10 | $33.38 | holding | — | — | — | Jan 19, 2017 | Jan 19, 2026 | Common Stock | 22,374 | 22,374 | D |
| Employee Stock Option (Right-to-Buy)F10 | $34.43 | holding | — | — | — | Oct 1, 2016 | Oct 1, 2025 | Common Stock | 7,207 | 7,207 | D |
| Employee Stock Option (Right-to-Buy)F10 | $50.10 | holding | — | — | — | Jan 26, 2018 | Jan 26, 2027 | Common Stock | 17,772 | 17,772 | D |
| Performance Stock Option (Right-to-Buy)F11 | $57.70 | holding | — | — | — | Jan 31, 2021 | Oct 20, 2027 | Common Stock | 62,552 | 62,552 | D |
| Performance Stock UnitsF12,F3,F5 | $0.00 | holding | — | — | — | Jan 26, 2018 | Jan 26, 2020 | Common Stock | 1,927 | 1,927 | D |
| Restricted Stock UnitsF9,F7,F8 | $0.00 | holding | — | — | — | Jan 26, 2018 | Jan 26, 2020 | Common Stock | 4,351 | 4,351 | D |
| Restricted Stock UnitsF9,F7,F8 | $0.00 | holding | — | — | — | Oct 1, 2016 | Oct 1, 2018 | Common Stock | 645 | 645 | D |
Explanation of responses
- F1Shares withheld for taxes due on 865 shares issued.
- F10This option vests in three equal annual installments beginning on the date shown.
- F11These 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.
- F12Amount includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature.
- F2Shares withheld for taxes due on 1,015 shares issued.
- F3These performance stock units convert into shares of common stock on a 1-for-1 basis.
- F4This amount reflects a 117.5% payout based on the performance criteria achieved.
- F5These performance stock units vest in three equal 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.
- F6This 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.
- F7These restricted stock units convert into shares of common stock on a 1-for-1 basis.
- F8These restricted stock units vest in three equal annual installments beginning on the date shown.
- F9Amount includes restricted stock units acquired pursuant to a dividend equivalent reinvestment feature.