SEC Form 4 · accession 0001209191-17-058272
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
Oct 26, 2017
Accepted (ET)
Oct 30, 2017 · 3:54 pm EDT
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 | May 5, 2017 | G | 177 | $0.00 | D | 33,574 | I | by spouse's trust |
| Common StockF1 | May 8, 2017 | G | 325 | $0.00 | D | 33,249 | I | by spouse's trust |
| Common StockF1 | May 9, 2017 | G | 311 | $0.00 | D | 32,938 | I | by spouse's trust |
| Common StockF2 | May 8, 2017 | G | 325 | $0.00 | A | 2,434 | I | by wife as UTMA custodian for son |
| Common StockF3 | May 9, 2017 | G | 311 | $0.00 | A | 2,458 | I | by wife as UTMA custodian for daughter |
| Common Stock | Oct 26, 2017 | M | 8,000 | $38.46 | A | 13,113 | D | |
| Common StockF4 | Oct 26, 2017 | S | 8,000 | $122.23 | D | 5,113 | D | |
| Common StockF5 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Options (right to buy)F6 | $38.46 | Oct 26, 2017 | M | 8,000 | D | Jan 31, 2015 | Jan 31, 2021 | Common Stock | 8,000 | 0 | D |
Explanation of responses
- F1Shares 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.
- F2Shares 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.
- F3Shares 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.
- F4Reflects the weighted average price of 8,000 shares of Common Stock sold by the reporting person in multiple transactions on October 26, 2017 with sale prices ranging from $122.00 to $123.00 per share. The reporting person undertakes to provide upon request by the U.S. Securities and Exchange Commission staff, the issuer, or a security holder of the issuer, full information regarding the number of shares sold at each separate price.
- F5Estimate of the number of shares held in the reporting person's ESOP fund as of October 26, 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.
- F6The option vested in two equal installments on January 31, 2013 and January 31, 2015.