SEC Form 4 · accession 0000726958-16-000198
CASEYS GENERAL STORES INC · CASY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Julia L Jackowski
Officer — SVP, Corp Gen Counsel
Period of report
Jun 2, 2016
Accepted (ET)
Jun 6, 2016 · 4:16 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000726958
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jun 2, 2016 | A | 2,978 | $0.00 | A | 17,767 | D | |
| Common StockF2 | holding | — | — | — | 4,023 | I | Voting and tender rights under 401K plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted stock unitsF3,F4 | — | Jun 2, 2016 | A | 3,250 | A | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF5,F4 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF6,F4 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF7,F4 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Option - right to buyF8 | $25.26 | holding | — | — | — | Jun 23, 2012 | Jun 23, 2019 | Common Stock | 12,500 | 12,500 | D |
| Option - right to buyF8 | $26.92 | holding | — | — | — | Jun 25, 2010 | Jun 25, 2017 | Common Stock | 4,000 | 4,000 | D |
| Option - right to buyF9 | $44.39 | holding | — | — | — | Jun 23, 2014 | Jun 23, 2021 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award represents the equity component of the amount payable to Ms. Jackowski under the fiscal 2016 annual incentive program. The shares awarded are subject to a three year sale restriction.
- F2Allocated to Ms. Jackowski's KSOP account as of April 30, 2016. Does not include any shares allocated by the KSOP trustee after that date.
- F3Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 2, 2019.
- F4Each restricted stock unit represents the right to receive, following vesting, one share of Common Stock.
- F5Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 7, 2016.
- F6Pursant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 6, 2017.
- F7Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 5, 2018.
- F8Pursuant to terms and conditions of 2000 Stock Option Plan.
- F9Pursuant to terms and conditions of 2009 Stock Incentive Plan.