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
TELEDYNE TECHNOLOGIES INC [ TDY ] |
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 | |||||||||||||
Common Stock | 09/22/2021 | G | 27,173(1) | D | $0 | 101,379.5376 | I | Trust(2) | |||||||
Common Stock | 10/06/2021(3) | G | 27,173(4) | D | $0 | 101,379.5376 | I | Trust(5) |
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 |
Explanation of Responses: |
1. On September 22, 2021, the Pichelli Living Trust distributed 27,173 shares to the Reporting Person and 27,173 shares to the Reporting Person's spouse. Pursuant to a Transmutation Agreement entered into between the Reporting Person and his spouse, the shares distributed to the Reporting Person would be deemed to be the separate property of Reporting Person and the shares distributed to Reporting Person's spouse would be deemed separate property of the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these securities distributed to his spouse except to the extent of his pecuniary interest therein, if any, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 promulgated under the Securities Exchange Act of 1934, as amended ("Section 16") or for any other purpose. |
2. Immediately following this transaction, Reporting Person held 44,614.5376 shares directly, 29,592 shares held indirectly by the Pichelli Living Trust and 27,173 shares held by the Reporting Person's spouse. Beneficial Ownership of the shares held by Reporting Person's spouse are disclaimed. Shares held directly include 8,195 restricted shares and 969.5376 shares purchased under the Employee Stock Purchase Plan based on information received as of January 22, 2021. |
3. Reporting Person ceased to be subject to the reporting requirements of Section 16 on October 15, 2021. |
4. Gift by Reporting Person to the Susan L. Pichelli 2021 Trust, a spousal lifetime access trust, the beneficiary of which is the Reporting Person's spouse. The Reporting Person disclaims beneficial ownership of these securities transferred to the Susan L. Pichelli 2021 Trust except to the extent of his pecuniary interest therein, if any, and the filing of this report is not an admission that the Reporting Person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. |
5. Immediately following this transaction, Reporting Person held 44,614.5376 shares directly, 29,592 shares held indirectly by the Pichelli Living Trust and 27,173 shares held indirectly by the Susan L. Pichelli 2021 Trust. Beneficial ownership of the shares held by the Susan L. Pichelli 2021 Trust is disclaimed. Shares held directly include 8,195 restricted shares and 969.5376 shares purchased under the Employee Stock Purchase Plan based on information received as of January 22, 2021. |
Remarks: |
Aldo Pichelli by S. Paul Sassalos pursuant to a Power of Attorney previously filed with the SEC. | 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. |