SEC Form 4 · accession 0000726958-17-000071
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
Jul 14, 2017
Accepted (ET)
Jul 18, 2017 · 3:09 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 | holding | — | — | — | 20,902 | D | ||
| Common StockF1 | 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 unitsF2,F3 | — | Jul 14, 2017 | A | 1,554 | A | — | — | Common Stock | 1,554 | 1,554 | D |
| Option - right to buyF4 | $25.26 | holding | — | — | — | Jun 23, 2012 | Jun 23, 2019 | Common Stock | 12,500 | 12,500 | D |
| Option - right to buyF5 | $44.39 | holding | — | — | — | Jun 23, 2014 | Jun 23, 2021 | Common Stock | 20,000 | 20,000 | D |
| Restricted stock unitsF6,F3 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
| Restricted stock unitsF7,F3 | — | holding | — | — | — | — | — | Common Stock | 3,250 | 3,250 | D |
Explanation of responses
- F1Allocated 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.
- F2Pursuant to terms and conditions of 2009 Stock Incentive Plan. This award will vest in full on June 15, 2020. Not included in the reported award amount is a target amount of performance-based restricted stock units that will vest on June 15, 2020, but which are subject to the satisfaction of certain performance criteria other than solely the price of Casey's Common Stock; the final amount of shares earned, if any, will be reported upon vest and satisfaction of those performance measures.
- F3Each performance stock unit represents the right to receive, following vesting, one share of Common Stock.
- F4Pursuant to terms and conditions of 2000 Stock Option Plan.
- F5Pursuant to terms and conditions of 2009 Stock Incentive Plan.
- 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.