SEC Form 5 · accession 0000048287-17-000034
HNI CORP · HNI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kurt A Tjaden
Officer — SVP HNI; President HNI Intl
Period of report
Dec 31, 2016
Accepted (ET)
Feb 13, 2017 · 9:09 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000048287
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Feb 29, 2016 | A | 1,510 | $0.00 | A | 35,606 | D | |
| Common StockF3 | Apr 1, 2016 | A | 193 | $39.55 | A | 35,799 | D | |
| Common StockF3 | Jul 1, 2016 | A | 164 | $46.68 | A | 35,963 | D | |
| Common StockF3 | Sep 30, 2016 | A | 192 | $39.80 | A | 36,155 | D | |
| Common StockF3 | Dec 30, 2016 | A | 37 | $55.92 | A | 36,192 | D | |
| Common StockF4 | Dec 30, 2016 | A | 182 | $0.00 | A | 1,021 | I | Profit-Sharing Retirement Plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1An interim grant of 1,510 shares was made to the reporting person on February 29, 2016, under the HNI Corporation Supplemental Income Plan for which no Form 4 is required.
- F2The total reported in Column 5 has been adjusted to correct an overstatement of direct holdings by 175.19 shares first reflected in a Form 5 filed on February 10, 2015.
- F3These shares were acquired during the fiscal year under the HNI Corporation 2002 Members' Stock Purchase Plan. This information is as of December 30, 2016.
- F4These shares were acquired under the HNI Corporation Profit-Sharing Retirement Plan. This information is as of December 30, 2016.