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*
Hein LeLand J

(Last) (First) (Middle)
2001 THEURER BLVD.

(Street)
WINONA MN 55987

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
FASTENAL CO [ FAST ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Operating Officer
3. Date of Earliest Transaction (Month/Day/Year)
12/01/2015
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 12/01/2015 M 50,000 A $22.5 62,390 D
Common Stock 12/01/2015 S 50,000 D $40.7393 12,390 (2) D
Common Stock 12/03/2015 M 50,000 A $22.5 62,390 D
Common Stock 12/03/2015 S 50,000 D $39.8838 12,390 (2) D
Common Stock 30 (3) I Held by Daughter
Common Stock 30 (3) I Held in custodian account for Son
Common Stock 150 (3) I Held by Son
Common Stock 7,988 (4) I Held in 401(K) Plan
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
Employee Stock Option (Right to Buy) $22.5 12/01/2015 M 50,000 (1) 05/31/2016 Common Stock 50,000 $0 50,000 D
Employee Stock Option (Right to Buy) $22.5 12/03/2015 M 50,000 (1) 05/31/2015 Common Stock 50,000 $0 0 D
Employee Stock Option (Right to Buy) $56 (5) 05/31/2023 Common Stock 112,500 112,500 D
Employee Stock Option (Right to Buy) $54 (5) 05/31/2021 Common Stock 37,500 37,500 D
Employee Stock Option (Right to Buy) $27 (1) 05/31/2018 Common Stock 50,000 50,000 D
Employee Stock Option (Right to Buy) $42 (5) 05/31/2024 Common Stock 19,047 (6) 19,047 D
Explanation of Responses:
1. The options will fully vest and become exercisable over a period of eight years, with 50% of the options vesting and becoming exercisable half way through the relevant vesting period, and remainder vesting and becoming exercisable proportionately each year thereafter.
2. Includes 300 shares maintained in a self directed IRA.
3. The reporting person disclaims beneficial ownership of these shares.
4. Shares attributed to reporting person's account within issuer's 401(K) Plan as of December 2, 2015.
5. The options will fully vest and become exercisable over a period of five years, with 50% of the options vesting and becoming exercisable half way through the relevant vesting period, and remainder vesting and becoming exercisable incrementally (20%, 20% and 10%) each year thereafter.
6. 10,714 of the 29,761 options granted to the reporting person on 4/21/2015 and reported on 4/23/2015 were forfeited and cancelled for no value on July 20, 2015.
John Milek, Attorney-in-Fact 12/03/2015
** 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.