0001225208-21-004030.txt : 20210301 0001225208-21-004030.hdr.sgml : 20210301 20210301155758 ACCESSION NUMBER: 0001225208-21-004030 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210226 FILED AS OF DATE: 20210301 DATE AS OF CHANGE: 20210301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: VAN SANT R WILLIAM CENTRAL INDEX KEY: 0001219030 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 21697572 MAIL ADDRESS: STREET 1: PO BOX 1441 CITY: MINNEAPOLIS STATE: MN ZIP: 55440-1441 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 2021-02-26 0000039368 FULLER H B CO FUL 0001219030 VAN SANT R WILLIAM 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Stock Units 0.0000 2021-02-26 4 A 0 588.5500 56.0700 A Common Stock 588.5500 107209.5200 D Stock Units 0.0000 1988-08-08 Common Stock 9032.2700 9032.2700 D These units convert into shares of common stock on a 1-for-1 basis. These units will be converted into shares of common stock upon retirement, death, disability or certain specified events, all as defined in such plan, subject to holding periods required by law. This amount includes stock units acquired pursuant to a dividend equivalent feature of the Directors' Deferred Compensation Plan. These units (acquired before 12-31-04) will be converted into shares of common stock upon retirement, death, disability or certain specified events, all as defined in such plan, subject to holding periods required by law. /s/ Timothy J. Keenan, Attorney-in-Fact 2021-03-01