0001225208-17-015879.txt : 20171004 0001225208-17-015879.hdr.sgml : 20171004 20171004112356 ACCESSION NUMBER: 0001225208-17-015879 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171002 FILED AS OF DATE: 20171004 DATE AS OF CHANGE: 20171004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JENSEN TRACI L CENTRAL INDEX KEY: 0001533627 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 171120783 MAIL ADDRESS: STREET 1: 1200 WILLOW LAKE BOULEVARD STREET 2: P.O. BOX 64683 CITY: ST. PAUL STATE: MN ZIP: 55164-0683 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FULLER H B CO CENTRAL INDEX KEY: 0000039368 STANDARD INDUSTRIAL CLASSIFICATION: ADHESIVES & SEALANTS [2891] IRS NUMBER: 410268370 STATE OF INCORPORATION: MN FISCAL YEAR END: 1203 BUSINESS ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 BUSINESS PHONE: 6126453401 4 1 doc4.xml X0306 4 2017-10-02 0000039368 FULLER H B CO FUL 0001533627 JENSEN TRACI L 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Sr.VP, Global Const Products Common Stock 2017-10-02 4 S 0 5397.0000 58.3950 D 14528.0000 D Employee Stock Option (Right-to-Buy) 22.2700 2021-01-20 Common Stock 12658.0000 12658.0000 D Employee Stock Option (Right-to-Buy) 23.6800 2020-04-14 Common Stock 6223.0000 6223.0000 D Employee Stock Option (Right-to-Buy) 33.3800 2026-01-19 Common Stock 29832.0000 29832.0000 D Employee Stock Option (Right-to-Buy) 41.0000 2025-01-22 Common Stock 22789.0000 22789.0000 D Employee Stock Option (Right-to-Buy) 48.9200 2024-01-23 Common Stock 16644.0000 16644.0000 D Employee Stock Option (Right-to-Buy) 50.1000 2018-01-26 2027-01-26 Common Stock 23696.0000 23696.0000 D Performance Stock Units 0.0000 2017-01-19 2019-01-19 Common Stock 2335.5900 2335.5900 D Performance Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 2563.0400 2563.0400 D Restricted Stock Units 0.0000 2019-01-19 Common Stock 2336.6000 2336.6000 D Restricted Stock Units 0.0000 2018-01-22 Common Stock 2047.6500 2047.6500 D Restricted Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 4296.9500 4296.9500 D The price reported is the weighted average sale price for the transaction reported. The prices received ranged from $58.36 to $58.51. The reporting person will provide to the issuer, a security holder of the issuer, or the SEC staff, upon request, full information regarding the number of shares sold at each price within the range. Amount includes 24,398 restricted shares awarded pursuant to H.B. Fuller Company's Amended and Restated Year 2000 Stock Incentive Plan and are 100% vested. Total amount also includes restricted shares acquired pursuant to a dividend accrual feature. This option is 100% vested. This option vests in three equal installments beginning on January 19, 2017. This option makes up part of the reporting person's fiscal year 2016 long-term incentive plan grant. This option vests in three equal annual installments beginning on January 22, 2016. This option vests in three equal installments beginning on the date shown. These performance stock units convert into shares of common stock on a 1-for-1 basis. These performance stock units vest in three annual installments beginning on the date shown upon H.B. Fuller achieving return on invested capital at least at the threshold level of performance in each year of the three years of vesting. These performance stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant. This amount has been adjusted to reflect the increase in number of performance stock units of the original grant based on performance criteria. Amount also includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature. These performance stock units vest in three annual installments beginning on the date shown upon H.B. Fuller achieving return on invested capital at least at the threshold level of performance in each year of the three years of vesting. These restricted stock units convert into shares of common stock on a 1-for-1 basis. These restricted stock units vest in three equal annual installments beginning on January 19, 2017. These restricted stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant. These restricted stock units vest in three equal annual installments beginning on January 22, 2016. These restricted units include stock units acquired pursuant to a dividend equivalent reinvestment feature. These restricted stock units vest in three equal annual installments beginning on the date shown. /s/ Timothy J. Keenan, Attorney-in-Fact 2017-10-04