0001225208-21-001109.txt : 20210125 0001225208-21-001109.hdr.sgml : 20210125 20210125182233 ACCESSION NUMBER: 0001225208-21-001109 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: Tometich Andrew E. CENTRAL INDEX KEY: 0001786083 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 21551109 MAIL ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD. STREET 2: P.O. BOX 64683 CITY: ST. PAUL STATE: MN ZIP: 55110 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 0001786083 Tometich Andrew E. 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Executive VP, HHC Common Stock 2021-01-24 4 M 0 1506.0000 52.7300 A 9260.0000 D Common Stock 2021-01-24 4 M 0 994.0000 52.7300 A 10254.0000 D Common Stock 2021-01-24 4 M 0 711.0000 52.7300 A 10965.0000 D Common Stock 2021-01-24 4 M 0 9.0000 52.7300 A 10974.0000 D Common Stock 2021-01-24 4 F 0 259.0000 52.7300 D 10715.0000 D Common Stock 2021-01-24 4 F 0 357.0000 52.7300 D 10358.0000 D Common Stock 2021-01-24 4 F 0 467.0000 52.7300 D 9891.0000 D Performance Stock Units 0.0000 2021-01-24 4 M 0 711.0000 52.7300 D 2021-01-24 2021-01-24 Common Stock 711.0000 0.0000 D Restricted Stock Units 0.0000 2021-01-24 4 M 0 1506.0000 52.7300 D 2022-01-24 Common Stock 1506.0000 1507.3900 D Restricted Stock Units 0.0000 2021-01-24 4 M 0 994.0000 52.7300 D 2021-01-24 2023-01-24 Common Stock 994.0000 2019.3900 D Employee Stock Option (Right-to-Buy) 46.1600 2019-10-17 2029-10-03 Common Stock 52301.0000 52301.0000 D Employee Stock Option (Right-to-Buy) 48.3500 2030-01-24 Common Stock 14492.0000 14492.0000 D Employee Stock Option (Right-to-Buy) 48.3500 2021-01-24 2030-01-24 Common Stock 28985.0000 28985.0000 D This amount reflects the number of shares acquired pursuant to dividend accruals during the vesting period. Shares withheld for taxes due on 720 shares issued. Shares withheld for taxes due on 994 shares issued. Shares withheld for taxes due on 1,506 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 is 100% vested. This option vests in two equal annual installments beginning on January 24, 2021. This option vests in three equal annual installments beginning on the date shown. /s/ Timothy J. Keenan, Attorney-in-Fact 2021-01-25