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*
Pigott John

(Last) (First) (Middle)
777 106TH AVENUE NE

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PACCAR INC [ PCAR ]
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)
06/09/2009
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 06/09/2009 S 4,184 D $34.1482 498,841(1) I TRUSTS HELD FOR CHILDREN
COMMON STOCK 06/06/2017 L(2) 51 A (2) 498,902(2)(3) I TRUSTS HELD FOR CHILDREN
COMMON STOCK(4) 150,351(3)(5) I GRATs
COMMON STOCK 1,627,344(5) 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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
STOCK UNITS (RSDCP)(6) (6) (6) (6) COMMON STOCK 28,356.689 28,356.689 D
Explanation of Responses:
1. The reporting person did not become aware of the June 2009 sale of 4,184 shares until a recent review of account balances. Accordingly, Forms 4 filed between June 9, 2009 and the date of this report over-reported the balance of the trust account by 4,184 shares.
2. Prior to a recent review of account balances, the reporting person was not aware that 51 shares had been acquired under a broker-administered DRIP from June 6, 2017 to December 5, 2018 at prices ranging from $59.32 to $74.85 per share. Accordingly, Forms 4 filed between June 6, 2017 and the date of this report under-reported the balance of the trust account.
3. All Forms 4 filed between March 8, 2016 and the date of this report over-reported the balance of the GRAT and under-reported the balance of the trust account by 10 shares due to a clerical error.
4. Shares held in Grantor Retained Annuity Trusts (GRATs).
5. Amounts reported also reflect the effect of a gratuitous transfer of 62,218 shares from the GRAT to directly held shares on March 17, 2016. Accordingly, Forms 4 filed between March 17, 2016 and the date of this report over-reported the balance of the GRAT and under-reported the balance of the directly held shares by 62,218 shares.
6. Restricted stock units held in deferred phantom stock account under PACCAR Restricted Stock and Deferred Compensation Plan for non-Employee Directors (RSDCP) convertible to PACCAR common stock on a 1-for-1 basis upon satisfaction of all applicable vesting conditions.
Remarks:
John M. Pigott by Irene E. Song POA 05/13/2019
** 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).
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