0001225208-21-001106.txt : 20210125 0001225208-21-001106.hdr.sgml : 20210125 20210125182217 ACCESSION NUMBER: 0001225208-21-001106 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210124 FILED AS OF DATE: 20210125 DATE AS OF CHANGE: 20210125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Malik Muhammad Shahbaz CENTRAL INDEX KEY: 0001621150 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 21551105 MAIL ADDRESS: STREET 1: 12950 WORLDGATE DRIVE STREET 2: SUITE 700 CITY: HERNDON STATE: VA ZIP: 20170 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: 1128 BUSINESS ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 BUSINESS PHONE: 6126453401 MAIL ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 4 1 doc4.xml X0306 4 2021-01-24 0000039368 FULLER H B CO FUL 0001621150 Malik Muhammad Shahbaz 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Senior Vice President Common Stock 2021-01-24 4 M 0 2008.0000 52.7300 A 2008.0000 D Common Stock 2021-01-24 4 M 0 620.0000 52.7300 A 2628.0000 D Common Stock 2021-01-24 4 M 0 444.0000 52.7300 A 3072.0000 D Common Stock 2021-01-24 4 M 0 5.0000 52.7300 A 3077.0000 D Common Stock 2021-01-24 4 F 0 159.0000 52.7300 D 2918.0000 D Common Stock 2021-01-24 4 F 0 220.0000 52.7300 D 2698.0000 D Common Stock 2021-01-24 4 F 0 652.0000 52.7300 D 2046.0000 D Performance Stock Units 0.0000 2021-01-24 4 M 0 444.0000 52.7300 D 2021-01-24 2021-01-24 Common Stock 444.0000 0.0000 D Restricted Stock Units 0.0000 2021-01-24 4 M 0 2008.0000 52.7300 D 2022-01-24 Common Stock 2008.0000 2009.8400 D Restricted Stock Units 0.0000 2021-01-24 4 M 0 620.0000 52.7300 D 2021-01-24 2023-01-24 Common Stock 620.0000 1263.1100 D Employee Stock Option (Right-to-Buy) 48.3500 2021-01-24 2030-01-24 Common Stock 18115.0000 18115.0000 D This amount reflects the number of shares acquired pursuant to dividend accruals during the vesting period. Shares withheld for taxes due on 449 shares issued. Shares withheld for taxes due on 620 shares issued. Shares withheld for taxes due on 2,008 shares issued. These performance stock units convert into shares of common stock on a 1-for-1 basis. These restricted stock units convert into shares of common stock on a 1-for-1 basis. These restricted stock units vest in two equal annual installments beginning on January 24, 2021. Amount includes restricted 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. This option vests in three equal annual installments beginning on the date shown. /s/ Timothy J. Keenan, Attorney-in-Fact 2021-01-25