SEC Form 4 · accession 0000726958-16-000314
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
Dec 20, 2016
Accepted (ET)
Dec 21, 2016 · 10:53 am EST
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 Stock | Dec 20, 2016 | G | 203 | $0.00 | D | 18,736 | D | |
| Common StockF1 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option - right to buyF2 | $26.92 | holding | — | — | — | Jun 25, 2010 | Jun 25, 2017 | Common Stock | 1,000 | 1,000 | D |
| Option - right to buyF2 | $25.26 | holding | — | — | — | Jun 23, 2012 | Jun 23, 2019 | Common Stock | 12,500 | 12,500 | D |
| Option - right to buyF3 | $44.39 | holding | — | — | — | Jun 23, 2014 | Jun 23, 2021 | Common Stock | 20,000 | 20,000 | D |
| Restricted stock unitsF4,F5 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF6,F5 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF7,F5 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
Explanation of responses
- F1Allocated to Ms. Jackowski's 401k plan account as of April 30, 2016. Does not include any shares allocated by the plan trustee after that date.
- F2Pursuant to terms and conditions of 2000 Stock Option Plan.
- F3Pursuant to terms and conditions of 2009 Stock Incentive Plan.
- F4Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 6, 2017.
- F5Each restricted stock unit represents the right to receive, following vesting, one share of Common Stock.
- F6Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 5, 2018.
- F7Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 2, 2019.