SEC Form 4 · accession 0000726958-17-000041
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, Sec
Period of report
Jun 6, 2017
Accepted (ET)
Jun 8, 2017 · 12:49 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 Stock | Jun 6, 2017 | M | 3,250 | $0.00 | A | 21,986 | D | |
| Common StockF1 | Jun 6, 2017 | F | 1,084 | $106.66 | D | 20,902 | D | |
| Common StockF2 | holding | — | — | — | 4,197 | 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 6, 2017 | M | 3,250 | D | — | — | Common Stock | 3,250 | 0 | D |
| Option - right to buyF5 | $26.92 | holding | — | — | — | Jun 25, 2010 | Jun 25, 2017 | Common Stock | 1,000 | 1,000 | D |
| Option - right to buyF5 | $25.26 | holding | — | — | — | Jun 23, 2012 | Jun 23, 2019 | Common Stock | 12,500 | 12,500 | D |
| Option - right to buyF6 | $44.39 | holding | — | — | — | Jun 23, 2014 | Jun 23, 2021 | Common Stock | 20,000 | 20,000 | D |
| Restricted stock unitsF7,F4 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF8,F4 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
Explanation of responses
- F1Closing price of Casey's General Stores, Inc. Common Stock on June 6, 2017.
- F2Allocated to Ms. Jackowski's 401k plan account as of April 30, 2017. Does not include any shares allocated by the plan trustee after that date.
- F3Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award vested in full on June 6, 2017.
- F4Each restricted stock unit represents the right to receive, following vesting, one share of Common Stock.
- F5Pursuant to terms and conditions of 2000 Stock Option Plan.
- F6Pursuant to terms and conditions of 2009 Stock Incentive Plan.
- 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 2009 Stock Incentive Plan. This award will vest in full on June 2, 2019.
Remarks
Exhibit 24 - Power of Attorney