SEC Form 4 · accession 0000791519-16-000094
STAPLES INC · SPLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shira Goodman
Officer — President NA Operations
Period of report
Mar 1, 2016
Accepted (ET)
Mar 3, 2016 · 5:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000791519
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Mar 1, 2016 | A | 63,382 | $0.00 | A | 66,384 | D | |
| Common Stock | Mar 2, 2016 | F | 20,557 | $9.70 | D | 45,827 | D | |
| Common Stock | Mar 2, 2016 | J | 42,825 | $0.00 | D | 3,002 | D | |
| Common Stock | Mar 2, 2016 | J | 42,825 | $0.00 | A | 173,577 | I | Shira D Goodman Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom Stock Unit 401(k)F4,F5 | — | holding | — | — | — | — | — | Common Stock | 773 | 773 | D |
| Phantom Stock Unit SERPF6,F5 | — | holding | — | — | — | — | — | Common Stock | 535 | 535 | D |
Explanation of responses
- F1Shares acquired upon settlement of 2013-2015 Performance Share Award.
- F2ESPP - Adjusted to reflect additional shares acquired through reporting person's participation in Staples Employee Stock Purchase Plan.
- F3Transfer from a direct holding to an indirect holding.
- F4Phantom Stock Units are held in a 401(k) and are payable in cash following the reporting person's termination of employment. Number of underlying shares of common stock is based on January 5, 2016 account statement and reflects acquisitions resulting from dividend reinvestment feature.
- F5See Table II, Column 2.
- F6Phantom Stock Units are held in a SERP and are payable in cash following the reporting person's termination of employment. Number of underlying shares of common stock is based on January 5, 2016 account statement and reflects acquisitions resulting from dividend reinvestment feature.