SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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).
1. Name and Address of Reporting Person*
Owens James

(Last) (First) (Middle)
1200 WILLOW LAKE BOULEVARD
P.O. BOX 64683

(Street)
ST. PAUL MN 55164-0683

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
FULLER H B CO [ FUL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President and CEO
3. Date of Earliest Transaction (Month/Day/Year)
10/04/2019
4. 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 Acquired, Disposed of, or Beneficially Owned
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 10/04/2019 M 33,275 A $20.57 219,672.776 D
Common Stock 10/04/2019 S 33,275 D $46.3413(1) 186,397.776 D
Common Stock 353.67(2) I By 401(k) Plan
Common Stock 280 I By Son(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right-to-Buy) $20.57 10/04/2019 M 33,275 12/03/2010(4) 12/03/2019 Common Stock 33,275 $20.57 0.0000 D
Employee Stock Option (Right-to-Buy) $22.27 01/20/2012(4) 01/20/2021 Common Stock 48,331 48,331 D
Employee Stock Option (Right-to-Buy) $25.19 07/07/2012(4) 07/07/2021 Common Stock 15,748 15,748 D
Employee Stock Option (Right-to-Buy) $28.4 01/26/2013(4) 01/26/2022 Common Stock 77,881 77,881 D
Employee Stock Option (Right-to-Buy) $33.38 01/19/2017(4) 01/19/2026 Common Stock 182,039 182,039 D
Employee Stock Option (Right-to-Buy) $39.64 01/24/2014(4) 01/24/2023 Common Stock 80,697 80,697 D
Employee Stock Option (Right-to-Buy) $41 01/22/2016(4) 01/22/2025 Common Stock 112,727 112,727 D
Employee Stock Option (Right-to-Buy) $45.04 01/24/2020(5) 01/24/2029(6) Common Stock 226,403 226,403 D
Employee Stock Option (Right-to-Buy) $48.92 01/23/2015(4) 01/23/2024 Common Stock 79,061 79,061 D
Employee Stock Option (Right-to-Buy) $50.1 01/26/2018(5) 01/26/2027 Common Stock 151,826 151,826 D
Employee Stock Option (Right-to-Buy) $53.57 01/25/2019(5) 01/25/2028 Common Stock 146,887 146,887 D
Performance Stock Option (Right-to-Buy) $57.7 01/31/2021(7) 10/20/2027 Common Stock 289,684 289,684 D
Performance Stock Units $0.0000(8) 01/24/2020(9) 01/24/2022 Common Stock 24,532.39 24,532.39(10) D
Performance Stock Units $0.0000(8) 01/25/2019(9) 01/25/2021 Common Stock 10,596.3 10,596.3(10) D
Performance Stock Units $0.0000(8) 01/26/2018(9) 01/26/2020 Common Stock 5,774.58 5,774.58(10) D
Performance Stock Units (CEO) $0.0000(8) 01/24/2020(11) 01/24/2020 Common Stock 9,118.47 9,118.47(10) D
Performance Stock Units (CEO) $0.0000(8) 01/24/2020(12) 01/24/2022 Common Stock 24,533.39 24,533.39(10) D
Performance Stock Units (CEO) $0.0000(8) 01/25/2019(12) 01/25/2021 Common Stock 10,600.31 10,600.31(10) D
Performance Stock Units (CEO) $0.0000(8) 01/26/2018(12) 01/26/2020 Common Stock 9,114.49 9,114.49(10) D
Explanation of Responses:
1. The price reported is the weighted average sale price for the transaction reported. The prices received ranged from $46.14 to $46.2950. 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.
2. This amount includes shares and dividends acquired pursuant to the H.B.Fuller Company 401(k) & Retirement Plan.
3. Held jointly by spouse and son.
4. This option is 100% vested.
5. This option vests in three equal annual installments beginning on the date shown.
6. This date was reported incorrectly on the Reporting Person's original Form 4, dated January 24, 2019, and has been updated with the correct expiration date.
7. These performance-based non-qualified stock options vest on the date shown contingent upon H.B. Fuller achieving adjusted EBITDA at least at the threshold level of performance.
8. These performance stock units convert into shares of common stock on a 1-for-1 basis.
9. These performance stock units vest in three equal 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.
10. Amount includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature.
11. These performance stock units vest in one annual installment beginning on the date shown, subject to one or more performance measures being achieved.
12. These performance stock units vest in three equal annual installments beginning on the date shown, subject to one or more performance measures being achieved.
/s/ Timothy J. Keenan, Attorney-in-Fact 10/07/2019
** 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 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).
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