SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Dodrill Amy M.

(Last) (First) (Middle)
130 EAST RANDOLPH STREET
SUITE 1000

(Street)
CHICAGO IL 60601

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/01/2019
3. Issuer Name and Ticker or Trading Symbol
Hill-Rom Holdings, Inc. [ HRC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President - Surgical Solutions
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 1,298 D
Common Stock 7.67 I By Hill-Rom Holdings, Inc. Employee Stock Purchase Plan
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) 02/22/2017(1) 02/22/2026 Common Stock 986 $46.28 D
Employee Stock Option (Right to Buy) 11/14/2017(2) 11/14/2026 Common Stock 1,207 $53.7 D
Employee Stock Option (Right to Buy) 11/08/2018(3) 11/08/2027 Common Stock 1,032 $78.16 D
Restricted Stock Units 11/17/2016(4) 11/17/2019(4) Common Stock 124.66 $0.0(5) D
Restricted Stock Units 11/15/2019(6) 11/15/2019(6) Common Stock 341.897 $0.0(5) D
Restricted Stock Units 11/09/2020(6) 11/09/2020(6) Common Stock 289.775 $0.0(5) D
Restricted Stock Units 11/08/2019(7) 11/08/2021(7) Common Stock 1,383.852 $0.0(5) D
Explanation of Responses:
1. Options vest 25% on each of February 22, 2017, 2018, 2019 and 2020.
2. Options vest 25% on each of November 14, 2017, 2018, 2019 and 2020.
3. Options vest 25% on each of November 8, 2018, 2019, 2020 and 2021.
4. Restricted stock units ("RSUs") vested 25% on November 17, 2016, 2017, 2018 and will vest 25% on November 17, 2019. RSUs will automatically be converted into shares of common stock on the date indicated and are entitled to dividend equivalent rights which accrue on dividend record dates.
5. RSUs convert into common stock on a one-for-one basis.
6. RSUs will vest in full on the day following the three-year anniversary of the grant date, subject to the reporting person's continued employment. RSUs will automatically be converted into shares of common stock on the date indicated and are entitled to dividend equivalent rights which accrue on dividend record dates.
7. RSUs will vest 34% on November 8, 2019, 33% on November 8, 2020 and 33% on November 8, 2021, subject to the reporting person's continued employment. RSUs will automatically be converted into shares of common stock on the date indicated and are entitled to dividend equivalent rights which accrue on dividend record dates.
Remarks:
/s/ Ari D. Mintzer as Attorney-in-Fact for Amy M. Dodrill 06/06/2019
** 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 5 (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.