0001225208-21-001169.txt : 20210126 0001225208-21-001169.hdr.sgml : 20210126 20210126173655 ACCESSION NUMBER: 0001225208-21-001169 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210125 FILED AS OF DATE: 20210126 DATE AS OF CHANGE: 20210126 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: 21555562 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: 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 2021-01-25 0000039368 FULLER H B CO FUL 0001533627 JENSEN TRACI L 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Vice President Common Stock 2021-01-25 4 M 0 813.0000 50.7500 A 17738.0000 D Common Stock 2021-01-25 4 M 0 529.0000 50.7500 A 18267.0000 D Common Stock 2021-01-25 4 F 0 154.0000 50.7500 D 18113.0000 D Common Stock 2021-01-25 4 F 0 237.0000 50.7500 D 17876.0000 D Performance Stock Units 0.0000 2021-01-25 4 M 0 529.0000 50.7500 D 2019-01-25 2021-01-25 Common Stock 529.0000 0.0000 D Restricted Stock Units 0.0000 2021-01-25 4 M 0 813.0000 50.7500 D 2019-01-25 2021-01-25 Common Stock 813.0000 0.0000 D Employee Stock Option (Right-to-Buy) 33.3800 2017-01-19 2026-01-19 Common Stock 29832.0000 29832.0000 D Employee Stock Option (Right-to-Buy) 41.0000 2016-01-22 2025-01-22 Common Stock 22789.0000 22789.0000 D Employee Stock Option (Right-to-Buy) 45.0500 2020-01-24 2029-01-24 Common Stock 27472.0000 27472.0000 D Employee Stock Option (Right-to-Buy) 48.3500 2021-01-24 2030-01-24 Common Stock 14492.0000 14492.0000 D Employee Stock Option (Right-to-Buy) 48.9200 2015-01-23 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 Employee Stock Option (Right-to-Buy) 53.5700 2019-01-25 2028-01-25 Common Stock 21834.0000 21834.0000 D Performance Stock Units 0.0000 2020-01-24 2022-01-24 Common Stock 1015.5300 1015.5300 D Restricted Stock Units 0.0000 2020-01-24 2022-01-24 Common Stock 1030.5500 1030.5500 D Restricted Stock Units 0.0000 2021-01-24 2023-01-24 Common Stock 1009.6900 1009.6900 D Shares withheld for taxes due on 529 shares issued. Shares withheld for taxes due on 813 shares issued. These performance stock units convert into shares of common stock on a 1-for-1 basis. 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. 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 the date shown. This option is 100% vested. This option vests in three equal annual installments beginning on the date shown. This amount has been adjusted to reflect a decrease in number of performance stock units from the original grant based on performance criteria. Amount also includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature. Amount includes restricted stock units acquired pursuant to a dividend equivalent reinvestment feature. /s/ Timothy J. Keenan, Attorney-in-Fact 2021-01-26