0001104659-17-030833.txt : 20170508 0001104659-17-030833.hdr.sgml : 20170508 20170508214927 ACCESSION NUMBER: 0001104659-17-030833 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170508 FILED AS OF DATE: 20170508 DATE AS OF CHANGE: 20170508 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEADWATERS INC CENTRAL INDEX KEY: 0001003344 STANDARD INDUSTRIAL CLASSIFICATION: CONCRETE PRODUCTS, EXCEPT BLOCK & BRICK [3272] IRS NUMBER: 870547337 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 10701 SOUTH RIVERFRONT PARKWAY STREET 2: SUITE 300 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8019849400 MAIL ADDRESS: STREET 1: 10701 SOUTH RIVERFRONT PARKWAY STREET 2: SUITE 300 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 FORMER COMPANY: FORMER CONFORMED NAME: COVOL TECHNOLOGIES INC DATE OF NAME CHANGE: 19951113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gehrmann William CENTRAL INDEX KEY: 0001308589 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32459 FILM NUMBER: 17824233 MAIL ADDRESS: STREET 1: 10653 S. RIVER FRONT PARKWAY STREET 2: SUITE 300 CITY: SOUTH JORDAN STATE: UT ZIP: 84095 4 1 a4.xml 4 X0306 4 2017-05-08 1 0001003344 HEADWATERS INC HW 0001308589 Gehrmann William 10701 S. RIVER FRONT PARKWAY, SUITE 300 SOUTH JORDAN UT 84095 0 1 0 0 Pres. Headwaters Resources COMMON STOCK 2017-05-08 4 D 0 77131 D 0 D STOCK APPRECIATION RIGHTS 13.57 2017-05-08 4 D 0 32813 D 2008-09-30 2017-09-30 Common Stock 32813 0 D STOCK APPRECIATION RIGHTS 9.84 2017-05-08 4 D 0 32813 D 2009-09-30 2018-09-30 Common Stock 32813 0 D STOCK APPRECIATION RIGHTS 4.60 2017-05-08 4 D 0 40000 D 2010-09-30 2019-09-30 Common Stock 40000 0 D STOCK APPRECIATION RIGHTS 3.81 2017-05-08 4 D 0 32927 D 2011-09-30 2020-09-30 Common Stock 32927 0 D STOCK APPRECIATION RIGHTS 1.85 2017-05-08 4 D 0 105904 D 2012-09-30 2021-09-30 Common Stock 105904 0 D STOCK APPRECIATION RIGHTS 6.79 2017-05-08 4 D 0 21049 D 2013-09-30 2022-09-30 Common Stock 21049 0 D STOCK APPRECIATION RIGHTS 9.19 2017-05-08 4 D 0 10291 D 2014-09-30 2023-09-30 Common Stock 10291 0 D STOCK APPRECIATION RIGHTS 13.03 2017-05-08 4 D 0 7917 D 2015-09-30 2024-09-30 Common Stock 7917 0 D STOCK APPRECIATION RIGHTS 17.83 2017-05-08 4 D 0 11807 D 2016-09-30 2015-09-30 Common Stock 11807 0 D Disposed of pursuant to the merger agreement between issuer and Boral Limited in exchange for the per-share right to receive $24.25 in cash, without interest. These stock appreciation rights were canceled in the merger in exchange for a cash payment of $5,341,683.33, without interest, representing the difference between the exercise price of the stock appreciation rights and the base price per share of the issuer's common stock subject to such stock appreciation rights. /s/ Harlan M. Hatfield For: William Gehrmann 2017-05-08