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
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1. Name and Address of Reporting Person*
Mulhall Christopher M.

(Last) (First) (Middle)
6920 SEAWAY BLVD

(Street)
EVERETT WA 98203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/25/2019
3. Issuer Name and Ticker or Trading Symbol
Fortive Corp [ FTV ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP - Chief Accounting 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 6,320(1) D
Common Stock 522(2) I By 401 (k)
Common Stock 4,892(3) I By Spouse
Common Stock 848(2) I By Spouse's 401 (k)
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
Employee Stock Option (Right to Buy) (4) 07/26/2021 Common Stock 1,926 $24.59 D
Employee Stock Option (Right to Buy) (4) 07/25/2022 Common Stock 2,275 $24.93 D
Employee Stock Option (Right to Buy) (4) 07/30/2023 Common Stock 1,742 $32.78 D
Employee Stock Option (Right to Buy) (4) 07/15/2024 Common Stock 1,475 $38.18 D
Employee Stock Option (Right to Buy) (4) 07/15/2025 Common Stock 2,172 $43.1 D
Employee Stock Option (Right to Buy) (4) 02/24/2026 Common Stock 3,627 $42.55 D
Employee Stock Option (Right to Buy) (4) 11/15/2025 Common Stock 1,680 $45.64 D
Employee Stock Option (Right to Buy) (4) 02/23/2027 Common Stock 3,350 $57.26 D
Employee Stock Option (Right to Buy) (4) 05/15/2027 Common Stock 620 $62.22 D
Employee Stock Option (Right to Buy) (4) 02/22/2028 Common Stock 3,060 $76.68 D
Employee Stock Option (Right to Buy) (4) 02/25/2029 Common Stock 3,430 $81.6 D
Executive Deferred Incentive Program - Fortive Stock Fund(5) (6) (6) Common Stock 200.5 (7) D
Employee Stock Option (Right to Buy) (4) 07/27/2020 Common Stock 2,398 $18.7 I By Spouse
Employee Stock Option (Right to Buy) (4) 07/26/2021 Common Stock 1,926 $24.59 I By Spouse
Employee Stock Option (Right to Buy) (4) 07/25/2022 Common Stock 2,275 $24.93 I By Spouse
Employee Stock Option (Right to Buy) (4) 07/30/2023 Common Stock 1,742 $32.78 I By Spouse
Employee Stock Option (Right to Buy) (4) 07/15/2024 Common Stock 1,947 $38.18 I By Spouse
Employee Stock Option (Right to Buy) (4) 07/15/2025 Common Stock 2,521 $43.1 I By Spouse
Employee Stock Option (Right to Buy) (4) 02/24/2026 Common Stock 2,541 $42.55 I By Spouse
Employee Stock Option (Right to Buy) (4) 02/23/2027 Common Stock 2,150 $57.26 I By Spouse
Employee Stock Option (Right to Buy) (4) 02/22/2028 Common Stock 2,040 $76.68 I By Spouse
Employee Stock Option (Right to Buy) (4) 02/25/2029 Common Stock 1,960 $81.6 I By Spouse
Explanation of Responses:
1. Includes 119 shares jointly owned with the Reporting Person's spouse and 3,575 Restricted Stock Units ("RSUs") held by the Reporting Person, with the RSUs subject to time-based vesting provisions and payable in shares of common stock on a one-to-one basis.
2. Based on plan statement dated as of October 31, 2019.
3. Includes 2,462 RSUs held by the Reporting Person's spouse, with the RSUs subject to time-based vesting provisions and payable in shares of common stock on a one-to-one basis.
4. Options vests ratably on an annual basis over a five-year period from the date of grant.
5. The reported securities are phantom shares in the Fortive stock fund (the "EDIP Stock Fund") under Fortive's Executive Deferred Incentive Program (the "EDIP").
6. The Reporting Person immediately vests in 100% of each voluntary contribution to the EDIP Stock Fund. The Reporting Person will vest in all contributions to the EDIP Stock Fund by the Issuer as follows: 100% upon the earlier of the Reporting Person's death, or upon retirement following at least 5 years of service with the Issuer and reaching the age of 55, or, if earlier, one-tenth per year of participation following five years of participation, in each case in accordance with the EDIP. Upon termination of employment, the vested portion of the EDIP Stock Fund is settled in the Issuer's common stock.
7. The notional shares convert on a one-to-one basis.
Remarks:
Daniel B. Kim, as attorney-in-fact 11/04/2019
** 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).
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