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 |
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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). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
FORD MOTOR CO [ F ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2021 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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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 | |||||||||||||
Class B Stock, $0.01 par value | 12/22/2021 | G | 750 | A | $0.00 | 40,748 | I | By Voting Trust - Individually(1) | |||||||
Class B Stock, $0.01 par value | 12/22/2021 | G | 1,500 | A | $0.00 | 42,136 | I | By Voting Trust - Spouse as Trustee(2) | |||||||
Class B Stock, $0.01 par value | 65,368 | I | By Voting Trust - By Trust(3) | ||||||||||||
Class B Stock, $0.01 par value | 19,633 | I | By Voting Trust - As Trustee(4) | ||||||||||||
Common Stock, $0.01 par value | 2,879 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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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 | |||||||||
Ford Stock Units | (5) | (5) | (5) | Common Stock, $0.01 par value | 8,608(5) | 8,608(5) | D | |||||||
Ford Stock Units | (6) | (6) | (6) | Common Stock, $0.01 par value | 6,104(6) | 6,104(6) | D | |||||||
Ford Stock Units | (7) | (7) | (7) | Common Stock, $0.01 par value | 708(7) | 708(7) | D |
Explanation of Responses: |
1. The voting trust holds 40,748 shares of Class B stock for my benefit. |
2. The voting trust holds 42,136 shares of Class B stock for the benefit of trusts, of which my spouse is trustee, that benefit my family. |
3. The voting trust holds 65,368 share of Class B stock for the benefit of a trust of which I am a beneficiary. |
4. The voting trust holds 19,633 shares of Class B stock for the benefit of a trust, of which I am trustee, that benefits my family. |
5. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 2,840 on March 4, 2022, 2,841 on March 4, 2023, and 2,927 on March 4, 2024. |
6. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 3,006 on March 4, 2022 and 3,098 on March 4, 2023. |
7. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 708 on March 4, 2022. |
Remarks: |
Victoria Pool, Attorney-in-Fact | 02/14/2022 | |
** 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. |