SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response: 1.0
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
SIMS RANDY D

(Last) (First) (Middle)
2800 ROCKCREEK PARKWAY

(Street)
NORTH KANSAS CITY MO 64117

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CERNER CORP /MO/ [ CERN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, CLO & Secretary
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
01/02/2016
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock 01/02/2016 J 105(1)(2) A $71.44(1)(2) 1,549 I by 401(k) Plan
Common Stock 01/02/2016 J 387(3) A $62.27(3) 2,297 I by ASPP account
Common Stock 890 D
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Option (right to buy) $10.055 03/14/2013 03/14/2018 Common Stock 60,000 60,000 D
Non-Qualified Stock Option (right to buy) $9.18 03/06/2011 03/06/2019 Common Stock 60,000 60,000 D
Non-Qualified Stock Option (right to buy) $21.3 03/12/2012 03/12/2020 Common Stock 48,000 48,000 D
Non-Qualified Stock Option (right to buy) $25.8 03/11/2013 03/11/2021 Common Stock 40,000 40,000 D
Non-Qualified Stock Option (right to buy) $38.43 03/09/2014 03/09/2022 Common Stock 40,000 40,000 D
Non-Qualified Stock Option (right to buy) $44.615 03/01/2015 03/01/2023 Common Stock 40,000 40,000 D
Non-Qualified Stock Option (right to buy) $60.37 03/07/2016 03/07/2024 Common Stock 33,500 33,500 D
Non-Qualified Stock Option (right to buy) $70.91 03/12/2017 03/12/2025 Common Stock 33,500 33,500 D
Non-Quallified Stock Option (right to buy) $1.6563 03/24/2007 03/24/2022 Common Stock 108,780 108,780 D
Explanation of Responses:
1. Full information regarding the number of shares purchased or sold at each separate price will be provided upon request by the Commission staff, Cerner Corporation, or a Cerner shareholder.
2. Represents shares acquired through routine payroll deduction and participation in the issuer's 401(k) plan between 01/04/2015 and 01/02/2016, at prices ranging from $64.94 to $75.00 per share. Balance is based on plan statement as of 01/02/2016. This transaction qualifies as a non-discretionary transaction from a tax-qualified plan.
3. Represents shares purchased through the associate stock purchase plan (ASPP) at $62.27 per share. Shares are purchased at a 15% discount on the last day of the purchase period.
Remarks:
/s/Patricia E. Davies, by Power of Attorney 01/15/2016
** 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.