0001659166-17-000262.txt : 20171208
0001659166-17-000262.hdr.sgml : 20171208
20171208193411
ACCESSION NUMBER: 0001659166-17-000262
CONFORMED SUBMISSION TYPE: 5/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161231
FILED AS OF DATE: 20171208
DATE AS OF CHANGE: 20171208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Pringle William W
CENTRAL INDEX KEY: 0001670864
FILING VALUES:
FORM TYPE: 5/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37654
FILM NUMBER: 171248128
MAIL ADDRESS:
STREET 1: C/O FORTIVE CORPORATION
STREET 2: 6920 SEAWAY BOULEVARD
CITY: EVERETT
STATE: WA
ZIP: 98203
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
5/A
1
wf-form5a_151277963685328.xml
FORM 5/A
X0306
5/A
2016-12-31
2017-01-04
0
0
0
0001659166
Fortive Corp
FTV
0001670864
Pringle William W
6920 SEAWAY BLVD
EVERETT
WA
98203
0
1
0
0
Senior Vice President
Common Stock
2016-12-28
5
G
0
L
193
0
D
5484
D
Due to an administrative error, the Reporting Person did not include in the Reporting Person's original Form 5 for the fiscal year ended December 31, 2016 ("Original Form 5") a donation of 193 shares of the Issuer's Common Stock made by the Reporting Person on December 28, 2016 to a charitable organization ("12/16 Donation"). This amendment to the Original Form 5 is being made to report the 12/16 Donation.
The amount identified in Column 5 of Table I of this amendment represents the number of shares of the Issuer's Common Stock owned by the Reporting Person as of December 28, 2016 following the 12/16 Donation and as of fiscal year ended December 31, 2016. As of December 8, 2017, the amount of shares of the Issuer's Common Stock beneficially owned by the Reporting Person was 13,973.
Daniel B. Kim, as attorney-in-fact
2017-12-08