SEC Form 4 · accession 0001238255-16-000285
JACK IN THE BOX INC · JACK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Raymond Pepper
Officer — VP - GENERAL COUNSEL
Period of report
Nov 28, 2016
Accepted (ET)
Nov 29, 2016 · 9:46 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000807882
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMON STOCKF1 | Nov 28, 2016 | A | 914 | $0.00 | A | 4,028 | D | |
| COMMON STOCKF2 | Nov 29, 2016 | S | 358 | $103.3968 | D | 3,670 | D | |
| COMMON STOCKF3 | Nov 29, 2016 | A | 592 | $0.00 | A | 4,262 | D | |
| COMMON STOCKF4 | Nov 29, 2016 | S | 40 | $103.4103 | D | 4,222 | D | |
| COMMON STOCKF4 | Nov 29, 2016 | S | 41 | $103.39 | D | 4,181 | D | |
| COMMON STOCKF4 | Nov 29, 2016 | S | 65 | $103.404 | D | 4,116 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NON QUALIFIED STOCK OPTIONF5 | $104.95 | Nov 29, 2016 | A | 1,794 | A | Nov 29, 2017 | Nov 29, 2023 | COMMON STOCK | 1,794 | 1,794 | D |
Explanation of responses
- F1Represents shares vested on 11/23/2016 and settled on 11/28/2016 for achievement of pre-established performance goals with respect to Performance Shares (as defined in Section 2.1 (aa) of our 2004 Stock Incentive Plan) granted for the three fiscal year performance period 2014-2016.
- F2Disposition of shares to satisfy tax withholding obligation upon vesting of Performance Shares on 11/23/2016.
- F3These securities are restricted stock units that vest in four equal installments commencing one year from the grant date, with after-tax net shares subject to a 50% holding requirement until separation of service from the Company.
- F4Disposition of shares to satisfy tax withholding obligation upon vesting of restricted stock units.
- F5These options become exercisable in three equal installments commencing one year after the date of grant.