SEC Form 4 · accession 0000791519-17-000045
STAPLES INC · SPLS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shira Goodman
Officer — CEO · Director
Period of report
Apr 22, 2017
Accepted (ET)
Apr 25, 2017 · 4:36 pm EDT
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 Stock | Apr 18, 2017 | J | 30,523 | $0.00 | D | 74,558 | D | |
| Common Stock | Apr 18, 2017 | J | 30,523 | $0.00 | A | 263,064 | I | Shira D Goodman Trust |
| Common Stock | Apr 22, 2017 | F | 10,800 | $9.72 | D | 63,758 | D | |
| Common Stock | Apr 24, 2017 | J | 12,153 | $0.00 | D | 51,605 | D | |
| Common Stock | Apr 24, 2017 | J | 12,153 | $0.00 | A | 275,217 | 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)F2,F3 | — | holding | — | — | — | — | — | Common Stock | 863 | 863 | D |
| Phantom Stock Unit SERPF4,F3 | — | holding | — | — | — | — | — | Common Stock | 572 | 572 | D |
Explanation of responses
- F1Transfer from a direct holding to an indirect holding.
- F2Phantom 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 April 6, 2017 account statement and reflects acquisitions resulting from dividend reinvestment feature.
- F3See Table II, Column 2
- F4Phantom 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 April 6, 2017 account statement and reflects acquisitions resulting from dividend reinvestment feature.