SEC Form 4 · accession 0001209191-17-006732
Polaris Inc. · PII
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael D. Dougherty
Officer — President-International
Period of report
Jan 30, 2017
Accepted (ET)
Feb 1, 2017 · 4:39 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000931015
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jan 30, 2017 | M | 185 | — | A | 5,185 | D | |
| Common StockF3 | Jan 30, 2017 | F | 72 | $83.55 | D | 5,113 | D | |
| Common StockF4 | holding | — | — | — | 33,751 | I | by spouse's trust | |
| Common StockF5 | holding | — | — | — | 2,109 | I | by wife as UTMA custodian for son | |
| Common StockF6 | holding | — | — | — | 2,147 | I | by wife as UTMA custodian for daughter | |
| Common StockF7 | holding | — | — | — | 4,715 | I | by ESOP |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Restricted Stock UnitsF2 | — | Jan 30, 2017 | M | 185 | D | — | Mar 15, 2017 | Common Stock | 185 | 0 | D |
Explanation of responses
- F1Shares acquired in settlement of an equal number of performance restricted stock units upon vesting of the units.
- F2Each performance restricted stock unit represents the right to receive one share of the Issuer's common stock upon the vesting of the units.
- F3Shares withheld to satisfy reporting person's tax withholding obligation upon the vesting and settlement of a performance restricted stock award.
- F4Shares held in a revocable trust of which the reporting person and his spouse are trustees, and the reporting person and his spouse, or other members of their family, are the beneficiaries.
- F5Shares held by son who shares reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his son, and this report should not be deemed an admission that the reporting person is the beneficial owner of his son's shares for purposes of Section 16 or for any other purpose.
- F6Shares held by daughter who shares reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his daughter, and this report should not be deemed an admission that the reporting person is the beneficial owner of his daughter's shares for purposes of Section 16 or for any other purpose.
- F7Estimate of the number of shares held in the reporting person's ESOP fund as of January 30, 2017. This plan uses unit accounting and the number of shares that a participant is deemed to hold varies with the price of Polaris stock.