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*
SIVER DARRIN C

(Last) (First) (Middle)
777 106TH AVE 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)
Director 10% Owner
X Officer (give title below) Other (specify below)
SENIOR VICE PRESIDENT
3. Date of Earliest Transaction (Month/Day/Year)
10/25/2019
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 10/25/2019 M 12,474 A $50 30,600 D
COMMON STOCK 10/25/2019 S 12,474 D $77.0053(2) 18,126 D
COMMON STOCK (SIP)(1) 12,282.07 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(3) $59.15 01/01/2017 02/07/2024 COMMON STOCK 9,236 9,236 D
STOCK OPTION(3) $62.46 01/01/2018 02/04/2025 COMMON STOCK 8,128 8,128 D
STOCK OPTION(3) $50 10/25/2019 M 12,474 01/01/2019 02/04/2026 COMMON STOCK 12,474 $0(3) 0 D
STOCK OPTION(3) $67.63 01/01/2020 02/07/2027 COMMON STOCK 13,774 13,774 D
STOCK OPTION(3) $68.69 01/01/2021 02/07/2028 COMMON STOCK 12,778 12,778 D
STOCK OPTION(3) $65.56 01/01/2022 02/06/2029 COMMON STOCK 16,274 16,274 D
STOCK UNITS (LTIP)(4) (4) (4) (4) COMMON STOCK 4,176 4,176 D
COMMON STOCK (DCP)(5) (5) (5) (5) COMMON STOCK 2,200.874 2,200.874 D
Explanation of Responses:
1. Shares held in PACCAR Savings Investment Plan (SIP).
2. The price shown is a weighted average sale price for shares sold in multiple transactions; the sale prices ranged from 77.0000 to 77.0500 per share. The reporting person will provide to the issuer, any security holder of the issuer, or the SEC staff, upon request, information regarding the number of shares sold at each price within the range.
3. Option to buy awarded under PACCAR LTIP.
4. Restricted stock units awarded under LTIP and convertible to common stock on a one-for-one basis upon satisfaction of all applicable vesting conditions. Each award vests in four equal installments commencing on March 1 following the award and January 1 of the next three years.
5. 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 vesting conditions.
Remarks:
Darrin C. Siver by Michael R. Beers POA 10/29/2019
** 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.
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.