SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Jenkins Charles R III

(Last) (First) (Middle)
3920 ARKWRIGHT RD
SUITE 200

(Street)
MACON GA 31210

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/15/2019
3. Issuer Name and Ticker or Trading Symbol
Blue Bird Corp [ BLBD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Operating Officer
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, par value $0.0001 per share 14,930(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) 01/03/2019 01/02/2027 Common Stock 3,268 $15.5 D
Stock Option (right to buy) 12/11/2018 12/10/2027 Common Stock 1,951 $18.1 D
Explanation of Responses:
1. Includes 6,932 Restricted Stock Units ("RSU") subject to future vesting. 1,416 RSUs awarded on January 3, 2017 will vest on January 3, 2020. 1,690 RSUs awarded on December 11, 2017, will vest 50% on December 11, 2019 and 50% on December 11, 2020. 3,826 RSU's were awarded on December 11, 2018 and will vest in thirds on each of December 11, 2019, 2020 and 2021. All RSU awards are subject to downward adjustment consistent with each respective fiscal year's actual percentage payout of the Management Performance bonus award.
Remarks:
/s/ Paul Yousif as attorney-in-fact 11/25/2019
** 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 5 (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.