SEC Form 4 · accession 0001127602-17-033354
DOLLAR TREE, INC. · DLTR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Joshua R Jewett
Officer — Chief Information Officer
Period of report
Oct 14, 2017
Accepted (ET)
Nov 28, 2017 · 3:12 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000935703
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Oct 14, 2017 | M | 1,684 | $0.00 | A | 6,976 | D | |
| Common Stock | Oct 14, 2017 | F | 555 | $91.50 | D | 6,421 | D | |
| Common Stock | Nov 28, 2017 | M | 1,481 | $76.97 | A | 7,902 | D | |
| Common Stock | Nov 28, 2017 | M | 2,089 | $68.92 | A | 9,991 | D | |
| Common Stock | Nov 28, 2017 | S | 3,570 | $99.00 | D | 6,421 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitF3,F1,F4 | $0.00 | Oct 14, 2017 | M | 1,684 | D | Oct 14, 2017 | Oct 14, 2017 | Common Stock | 1,684 | 0 | D |
| Stock Option (right to buy)F5,F6,F7 | $76.97 | Nov 28, 2017 | M | 1,481 | D | — | Oct 14, 2024 | Common Stock | 1,481 | 1,480 | D |
| Stock Option (right to buy)F5,F7,F8 | $68.92 | Nov 28, 2017 | M | 2,089 | D | — | Oct 15, 2018 | Common Stock | 2,089 | 0 | D |
Explanation of responses
- F1Convert without cost to shares of common stock on a one-for-one basis.
- F2Shares deemed surrendered in payment of tax liability resulting from vesting of restricted stock units.
- F3Pursuant to the Merger Agreement, on July 6, 2015, the outstanding restricted stock unit award granted on October 14, 2014 under Family Dollar equity award policy, was coverted into a restricted stock unit award in respect of a number of shares of Dollar Tree common stock determined by multiplying the number of shares of Family Dollar stock by the Award Exchange Ratio of 1.0000.
- F4Restricted Stock Unit granted on October 14, 2014 and will fully vest on the third anniversary of grant date.
- F5Pursuant to the Merger Agreement dated July 6, 2015, each option to purchase shares of Family Dollar common stock that was outstanding immediately prior to the Effective Time was converted into an option to purchase a number of shares of Dollar Tree common stock determined by multiplying the number of shares of Family Dollar common stock subject to such option by the Award Exchange Ratio of 1.000, at an exercise price per share determined by dividing the orginal per share exercise price of the option by the Award Exchange Ratio of 1.000.
- F6Award granted on October 14, 2014.
- F7Each option becomes exercisable with respect to 40% of the underlying shares on the second anniversary of grant and with respect to an additional 30% on each of the third and fourth anniversaries of grant.
- F8Award was granted on October 15, 2013.