SEC Form 5 · accession 0001127602-16-038504
PUBLIX SUPER MARKETS INC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David E Bornmann
Officer — Vice President
Period of report
Dec 26, 2015
Accepted (ET)
Jan 29, 2016 · 4:57 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000081061
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Apr 14, 2015 | W | 2,657 | $39.05 | A | 83,912 | D | |
| Common StockF1 | holding | — | — | — | 1,839 | I | By 401(k) | |
| Common Stock | holding | — | — | — | 907 | I | By Child | |
| Common Stock | holding | — | — | — | 1,157 | I | By Custodian for Child | |
| Common StockF2 | holding | — | — | — | 51,861 | I | By ESOP | |
| Common Stock | holding | — | — | — | 14,125 | I | By Spouse | |
| Common Stock | holding | — | — | — | 4,687 | I | By Spouse's Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SERP StockF3 | — | holding | — | — | — | — | — | Common Stock | 1,919 | 1,919 | I |
Explanation of responses
- F1Acquired under the Publix Super Markets, Inc. 401(k) SMART Plan. Transaction exempt under rule 16b-3(c).
- F2Acquired under the Publix Super Markets, Inc. Employee Stock Ownership Plan. Transaction exempt under rule 16b-3(c).
- F3Each share of SERP stock is the economic equivalent of one share of common stock. The shares of SERP stock become payable in common stock upon the reporting person's termination of employment in accordance with the Publix Super Markets, Inc. Supplemental Executive Retirement Plan.