SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
JANDERNOA MICHAEL J

(Last) (First) (Middle)
C/O PERRIGO COMPANY
515 EASTERN AVENUE

(Street)
ALLEGAN MI 49010

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PERRIGO CO [ PRGO ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
08/27/2009
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/27/2009 G V 8,970 D $0 2,520,000 I By Trust.(1)
Common Stock 08/28/2009 G V 760 D $0 2,519,240 I By Trust.(1)
Common Stock 09/01/2009 G V 3,084 D $0 2,516,156 I By Trust.(1)
Common Stock 09/02/2009 G V 1,528 D $0 2,514,628 I By Trust.(1)
Common Stock 09/03/2009 G V 3,342 D $0 2,511,286 I By Trust.(1)
Common Stock 11/03/2009 G V 8,650 D $0 2,502,636 I By Trust.(1)
Common Stock 11/09/2009 G V 4,286 D $0 2,366,250(3) I By Trust.(1)
Common Stock 11/16/2009 G V 4,346 D $0 2,361,904 I By Trust.(1)
Common Stock 11/16/2009 J(2) 337,670 D $39.6643 2,024,234 I By Trust.(1)
Common Stock 5,115 D
Common Stock 132,100 I By Trust.(3)
Common Stock 183,838 I By Trust.(4)(5)
Common Stock 132,100 I By Trust.(5)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Variable Prepaid Stock Purchase Agreements(6) $39.6643 11/16/2009 J(2) 337,670 11/16/2009 11/16/2009 Common Stock 385,000 $0 0 I By Trust.(1)
Explanation of Responses:
1. Michael J. Jandernoa Trust of which the reporting person is the Trustee.
2. See attached page.
3. On November 3, 2009, the Michael J. Jandernoa Trust contributed 132,100 shares of common stock of Perrigo Company ("Common Stock") to the Michael J. Jandernoa 2009 2-Year Grantor Trust. The Michael J. Jandernoa 2009 2-Year Grantor Trust directly holds 132,100 shares of Common Stock.
4. Susan M. Jandernoa Trust of which Mrs. Jandernoa is the Trustee.
5. On November 3, 2009, the Susan M. Jandernoa Trust contributed 132,100 shares of Common Stock to the Susan M. Jandernoa 2009 2-Year Grantor Trust. The Susan M. Jandernoa 2009 2-Year Grantor Trust directly holds 132,100 shares of Common Stock.
6. Variable Prepaid Stock Purchase Agreements (Right and Obligation to Sell).
Todd Kingma, Power of Attorney for Michael J. Jandernoa 11/18/2009
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.