SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Campe Heather

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

(Street)
ST. PAUL MN 55164-0683

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/01/2021
3. Issuer Name and Ticker or Trading Symbol
FULLER H B CO [ FUL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr. VP, International Growth
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 1,074.19 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right-to-Buy) 01/24/2020(1) 01/24/2029 Common Stock 27,472 $45.05 D
Employee Stock Option (Right-to-Buy) 01/24/2021(1) 01/24/2030 Common Stock 25,555 $48.35 D
Employee Stock Option (Right-to-Buy) 01/23/2015(2) 01/23/2024 Common Stock 7,323 $48.92 D
Employee Stock Option (Right-to-Buy) 01/26/2018(2) 01/26/2027 Common Stock 23,696 $50.1 D
Employee Stock Option (Right-to-Buy) 01/27/2022(1) 01/27/2031 Common Stock 19,520 $51.89 D
Employee Stock Option (Right-to-Buy) 01/25/2019(2) 01/25/2028 Common Stock 21,834 $53.57 D
Phantom Units (3) (3) Common Stock 1,838.5(4) $0.0000(5) D
Restricted Stock Units 01/24/2020(6) 01/24/2022 Common Stock 1,041(7) $0.0000(8) D
Restricted Stock Units 01/24/2021(6) 01/24/2023 Common Stock 1,799(7) $0.0000(8) D
Restricted Stock Units 01/27/2022(6) 01/27/2024 Common Stock 2,505(7) $0.0000(8) D
Restricted Stock Units 08/01/2022(9) 08/01/2022 Common Stock 9,985(7) $0.0000(8) D
Restricted Stock Units 11/01/2022(9) 11/01/2022 Common Stock 1,534 $0.0000(8) D
Explanation of Responses:
1. This option vests in three equal annual installments beginning on the date shown.
2. This option is 100% vested.
3. These units (acquired after 12-31-04) convert into shares of common stock upon the earlier of certain termination events as specified in the Key Employee DeferredCompensation Plan or such earlier date as selected by the participant, subject to holding periods required by law.
4. Amount includes stock units acquired pursuant to a dividend equivalent feature.
5. These units (acquired after 12-31-04) convert into shares of common stock on a 1-for-1 basis.
6. These restricted stock units vest in three equal annual installments beginning on the date shown.
7. Amount includes restricted stock units acquired pursuant to a dividend equivalent reinvestment feature.
8. These restricted stock units convert into shares of common stock on a 1-for-1 basis.
9. These restricted stock units vest in one annual installment on the date shown.
/s/ Timothy J. Keenan, Attorney-in-Fact 12/08/2021
** 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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.