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*
LUNDQUIST NICHOLAS J

(Last) (First) (Middle)
2001 THEURER BOULEVARD

(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
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
02/01/2021
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 02/01/2021 G V 5,000 D $0 421,000 D
Common Stock 07/15/2021 M 8,726 A $53.295 429,726 D
Common Stock 07/16/2021 M 9,000 A $53.51 438,726 D
Common Stock 07/16/2021 G(7) 9,000 D $0 429,726 D
Common Stock 07/16/2021 G(7) 9,000 A $0 65,000 I Owned by Spouse
Common Stock 17,344(6) 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
Employee Stock Option (Right to Buy) $27.5(2) 07/15/2021 M 8,726(2) (1) 12/31/2027 Common Stock 8,726(2) $0 0(2)(3) D
Employee Stock Option (Right to Buy) $23.5(4) 07/16/2021 M 9,000(4) (1) 12/31/2026 Common Stock 9,000(4) $0 11,426(4)(5) D
Explanation of Responses:
1. The option will fully vest and become exercisable over a period of five years, with 40% vesting and becoming exercisable two years following the date of grant and the remainder vesting and becoming exercisable proportionately (20%, 20% and 20%) each year thereafter.
2. The option was previously reported in a filing on 1/3/2018 as covering 10,909 securities at an exercise price of $55 and the amounts reported were adjusted to reflect a 2-for-1 stock split on May 22, 2019.
3. The reporting person retired as an employee in January 2020 and forfeited 13,092 securities upon his retirement.
4. The option was previously reported in a filing on 1/24/2017 as covering 17,021 securities at an exercise price of $47 and the amounts reported were adjusted to reflect a 2-for-1 stock split on May 22, 2019.
5. The reporting person retired as an employee in January 2020 and forfeited 13,616 securities upon his retirement.
6. Shares maintained in a self-directed IRA.
7. Reporting person gifted these share to his spouse.
/s/ John Milek, Attorney-in-Fact 07/19/2021
** 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.