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*
RUDOLPH PHILLIP H

(Last) (First) (Middle)
9330 BALBOA AVENUE

(Street)
SAN DIEGO CA 92123

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
JACK IN THE BOX INC /NEW/ [ JACK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, CHF LGL/RISK OFCR & SEC
3. Date of Earliest Transaction (Month/Day/Year)
11/29/2018
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 11/29/2018 A 2,519(1) A $0 100,648 D
COMMON STOCK 11/30/2018 S 881(2) D $87.6623 99,767 D
COMMON STOCK 11/29/2018 A 5,012(3) A $0 104,779 D
COMMON STOCK 11/30/2018 S 562(4) D $87.6613 104,217 D
COMMON STOCK 11/30/2018 S 250(4) D $87.6614 103,967 D
COMMON STOCK 11/30/2018 S 252(4) D $87.6616 103,715 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
Explanation of Responses:
1. Represents shares vested and issued on 11/29/2018 for achievement of pre-established performance goals with respect to Performance Shares (as defined in Section 2.1 (aa) of our 2004 Stock Incentive Plan) granted for the three fiscal year performance period 2016-2018.
2. Disposition of shares to satisfy tax withholding obligation upon vesting and issuance of Performance Shares (as defined in Section 2.1 (aa) of our Stock Stock Incentive Plan) pursuant to 10b5-1 sales instruction in grant agreement.
3. These securities are restricted stock units that vest in four equal installments commencing one year from the grant date, with after-tax net shares subject to a 50% holding requirement until separation of service from the Company.
4. Disposition of shares to satisfy tax withholding obligation upon vesting of restricted stock units pursuant to 10b5-1 sales instruction in grant agreement.
Remarks:
PHILLIP H RUDOLPH 11/29/2018
** 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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