SEC Form 4 · accession 0001179110-16-023280
FASTENAL CO · FAST
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Gary A. Polipnick
Officer — Executive Vice President
Period of report
Apr 19, 2016
Accepted (ET)
Apr 21, 2016 · 3:30 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000815556
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF3 | holding | — | — | — | 61,059 | D | ||
| Common Stock | holding | — | — | — | 898 | I | Held by Spouse | |
| Common StockF4 | holding | — | — | — | 1,862 | I | Held in custodian account for Daughter | |
| Common StockF4 | holding | — | — | — | 963 | I | Held in custodian account for Daughter | |
| Common StockF5 | holding | — | — | — | 6,997 | I | Held in 401(K) Plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F1 | $46.00 | Apr 19, 2016 | A | 9,782 | A | — | May 31, 2025 | Common Stock | 9,782 | 9,782 | D |
| Employee Stock Option (Right to Buy)F2 | $27.00 | holding | — | — | — | — | May 31, 2018 | Common Stock | 30,000 | 30,000 | D |
| Employee Stock Option (Right to Buy)F1 | $54.00 | holding | — | — | — | — | May 31, 2021 | Common Stock | 2,500 | 2,500 | D |
| Employee Stock Option (Right to Buy)F1 | $56.00 | holding | — | — | — | — | May 31, 2023 | Common Stock | 80,000 | 80,000 | D |
| Employee Stock Option (Right to Buy)F1 | $42.00 | holding | — | — | — | — | May 31, 2024 | Common Stock | 10,714 | 10,714 | D |
Explanation of responses
- F1These options will fully vest and become exercisable over a period of five years, with 50% vesting and becoming exercisable halfway through the relevant vesting period, and the remainder vesting and becoming exercisable incrementally (20%, 20% and 10%) each year thereafter.
- F2These options will fully vest and become exercisable over a period of eight years, with 50% vesting and becoming exercisable halfway through the relevant vesting period, and the remainder vesting and becoming exercisable proportionately each year thereafter.
- F3Includes 1,735 shares maintained in a self-directed IRA.
- F4Reporting person disclaims beneficial ownership of these shares.
- F5Shares attributed to reporting person's account with issuer's 401(K) Plan as of April 20, 2016.