SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
PIGOTT MARK C

(Last) (First) (Middle)
777 106TH AVENUE NE

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PACCAR INC [ PCAR ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Chairman
3. Date of Earliest Transaction (Month/Day/Year)
09/04/2019
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
COMMON STOCK 2,886,445 D
COMMON STOCK 283,280 I WIFE AND CHILDREN
COMMON STOCK (SIP)(1) 09/04/2019 J(2) 422.79 A $65.46 90,681.889(3) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
STOCK OPTION(4) $36.12 01/01/2013 02/02/2020 COMMON STOCK 134,492 134,492 D
STOCK OPTION(4) $50.5 01/01/2014 02/03/2021 COMMON STOCK 92,832 92,832 D
STOCK OPTION(4) $43.24 01/01/2015 02/02/2022 COMMON STOCK 134,084 134,084 D
STOCK OPTION(4) $47.81 01/01/2016 02/06/2023 COMMON STOCK 108,714 108,714 D
STOCK OPTION(4) $59.15 01/01/2017 02/07/2024 COMMON STOCK 85,618 85,618 D
COMMON STOCK (LTIP)(5) (5) 09/04/2019 J(6) 229.285 (5) (5) COMMON STOCK 229.285 $65.46 47,132.317 D
COMMON STOCK (DICP)(7) (7) 09/04/2019 J(8) 571.434 (7) (7) COMMON STOCK 571.434 $65.46 117,465.503 D
COMMON STOCK (DCP)(9) (9) 09/04/2019 J(10) 174.7 (9) (9) COMMON STOCK 174.7 $65.46 35,911.652 D
Explanation of Responses:
1. Shares held in PACCAR Savings Investment Plan (SIP).
2. Dividend on SIP shares reinvested pursuant to SIP.
3. Balance includes shares awarded under SIP (Company match) since date of last report in a transaction that was exempt under both Rule 16b-3(d) and Rule 16b-3 (c).
4. Option to buy awarded under PACCAR Long Term Incentive Plan (LTIP).
5. Share units held in deferred phantom stock account under LTIP convertible to common stock on a one for one basis upon satisfaction of all applicable conditions.
6. Dividend on share units held in deferred phantom stock account under LTIP reinvested pursuant to LTIP.
7. Share units held in deferred phantom stock account under PACCAR Deferred Incentive Compensation Plan (DICP) convertible to common stock on a one for one basis upon satisfaction of all applicable conditions.
8. Dividend on share units held in deferred phantom stock account under DICP reinvested pursuant to DICP.
9. Share units held in deferred phantom stock account under PACCAR Deferred Compensation Plan (DCP) convertible to common stock on a one for one basis upon satisfaction of all applicable conditions
10. Dividend on share units held in deferred phantom stock account under DCP reinvested pursuant to DCP.
Remarks:
Mark C. Pigott 09/06/2019
** 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 4 (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.
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