SEC Form 4 · accession 0001179110-16-018906
USANA HEALTH SCIENCES INC · USNA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ronald S Poelman
Director
Period of report
Feb 8, 2016
Accepted (ET)
Feb 10, 2016 · 5:53 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000896264
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Deferred Stock UnitF1,F2 | — | Feb 8, 2016 | A | 2,000 | A | — | — | Common Stock | 2,000 | 2,000 | D |
Explanation of responses
- F1Each Deferred Stock Unit ("DSU") represents the issuer's obligation to transfer one share of common stock in accordance with the terms of the deferred stock unit agreement pursuant to which the DSU's were granted.
- F2Following termination of the undersigned's service on the issuer's Board of Directors, the issuer will distribute to the undersigned shares of common stock equal to the number of DSU's granted.