SEC Form 4 · accession 0000726958-17-000049
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 19, 2017
Accepted (ET)
Jun 21, 2017 · 12:12 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 19, 2017 | M | 1,000 | $26.92 | A | 21,902 | D | |
| Common StockF1 | Jun 19, 2017 | S | 1,000 | $108.09 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option - right to buyF3 | $26.92 | Jun 19, 2017 | M | 1,000 | D | Jun 25, 2010 | Jun 25, 2017 | Common Stock | 1,000 | 0 | D |
| Option - right to buyF3 | $25.26 | holding | — | — | — | Jun 23, 2012 | Jun 23, 2019 | Common Stock | 12,500 | 12,500 | D |
| Option - right to buyF4 | $44.39 | holding | — | — | — | Jun 23, 2014 | Jun 23, 2021 | Common Stock | 20,000 | 20,000 | D |
| Restricted stock unitsF5,F6 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF7,F6 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
Explanation of responses
- F1The price reported is a weighted average price provided by the broker. These shares were sold in multiple transactions at prices ranging from $108.07 to $108.16. Ms. Jackowski undertakes to provide to Casey's General Store, Inc., any security holder thereof, or the staff of the SEC, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
- 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 2000 Stock Option Plan.
- F4Pursuant to terms and conditions of 2009 Stock Incentive Plan.
- F5Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 5, 2018.
- F6Each restricted stock unit represents the right to receive, following vesting, one share of Common Stock.
- F7Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 2, 2019.