0000899243-19-015764.txt : 20190606 0000899243-19-015764.hdr.sgml : 20190606 20190606161535 ACCESSION NUMBER: 0000899243-19-015764 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190604 FILED AS OF DATE: 20190606 DATE AS OF CHANGE: 20190606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RALES STEVEN M CENTRAL INDEX KEY: 0001015013 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37654 FILM NUMBER: 19882777 MAIL ADDRESS: STREET 1: 1250 24TH ST NW STREET 2: 8TH FL CITY: WASHINGTON STATE: DC ZIP: 20037 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fortive Corp CENTRAL INDEX KEY: 0001659166 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6920 SEAWAY BLVD. CITY: EVERETT STATE: WA ZIP: 98203 BUSINESS PHONE: (425) 446-5000 MAIL ADDRESS: STREET 1: 6920 SEAWAY BLVD. CITY: EVERETT STATE: WA ZIP: 98203 FORMER COMPANY: FORMER CONFORMED NAME: TGA Holding Corp. DATE OF NAME CHANGE: 20151123 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-06-04 0 0001659166 Fortive Corp FTV 0001015013 RALES STEVEN M 2200 PENNSYLVANIA AVENUE, NW SUITE 800W WASHINGTON DC 20037 1 0 0 0 Common Stock 2019-06-04 4 A 0 2210 0.00 A 4517475 D Common Stock 2019-06-04 4 A 0 1385 79.52 A 4518860 D Common Stock 17000000 I Through single-member LLCs On June 4, 2019, the Issuer granted to the Reporting Person restricted stock units ("Annual Grant RSUs") of the Issuer in the amount indicated as an annual equity grant made to the Reporting Person. Since the Annual Grant RSUs are payable solely in common stock, they are being reported in Table I of this Form 4. The Annual Grant RSUs vest on the earlier of the first anniversary of the grant date or the date of the Issuer's 2020 annual meeting of the stockholders, but the underlying shares will not be issued until the earlier of the Reporting Person's death or the first day of the seventh month following the Reporting Person's retirement from the Board of Directors of the Issuer. On June 4, 2019, the Issuer granted to the Reporting Person restricted stock units ("Deferral RSUs") of the Issuer in the amount indicated, based on a 20-day average price of $79.52, pursuant to deferral election made by the Reporting Person of $110,000 in annual retainer that would otherwise have been paid in cash. Since the Deferral RSUs are payable solely in common stock, they are being reported in Table I of this Form 4. The Deferral RSUs vest on the earlier of the first anniversary of the grant date or the date of the Issuer's 2020 annual meeting of the stockholders, but the underlying shares will not be issued until the earlier of the Reporting Person's death or the first day of the seventh month following the Reporting Person's retirement from the Board of Directors of the Issuer. The reported shares are held through single-member LLCs, of which a revocable trust with the Reporting Person as the sole trustee and beneficiary is the sole member of these LLCs. /s/ Steven M. Rales 2019-06-06