0001659166-21-000152.txt : 20210517
0001659166-21-000152.hdr.sgml : 20210517
20210517184712
ACCESSION NUMBER: 0001659166-21-000152
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210514
FILED AS OF DATE: 20210517
DATE AS OF CHANGE: 20210517
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Underwood Peter C
CENTRAL INDEX KEY: 0001502370
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37654
FILM NUMBER: 21933129
MAIL ADDRESS:
STREET 1: 200 STATE STREET
CITY: BELOIT
STATE: WI
ZIP: 53511
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fortive Corp
CENTRAL INDEX KEY: 0001659166
STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6920 SEAWAY BLVD.
CITY: EVERETT
STATE: WA
ZIP: 98203
BUSINESS PHONE: (425) 446-5000
MAIL ADDRESS:
STREET 1: 6920 SEAWAY BLVD.
CITY: EVERETT
STATE: WA
ZIP: 98203
FORMER COMPANY:
FORMER CONFORMED NAME: TGA Holding Corp.
DATE OF NAME CHANGE: 20151123
4
1
wf-form4_162129161261683.xml
FORM 4
X0306
4
2021-05-14
0
0001659166
Fortive Corp
FTV
0001502370
Underwood Peter C
6920 SEAWAY BLVD
EVERETT
WA
98203
0
1
0
0
SVP - General Counsel
Common Stock
2021-05-14
4
M
0
2295
0
A
46970
D
Common Stock
2021-05-14
4
F
0
559
70.61
D
46411
D
Restricted Stock Unit
2021-05-14
4
M
0
2295
0
D
Common Stock
2295.0
0
D
Restricted stock units are payable in shares of common stock on a one-to-one basis.
In connection with the spin-off of Vontier Corporation by the Issuer, outstanding Restricted Stock Units ("RSUs"), including RSUs previously granted to the Reporting Person, were subject to anti-dilution adjustments ("Anti-Dilution Adjustment"). The total number of RSUs reported include the additional RSUs held by the Reporting Person as a result of the Anti-Dilution Adjustment.
In connection with the separation of the Issuer from Danaher, RSUs issued by Danaher on May 15, 2016 to the Reporting Person vesting in five equal annual installments that remained unvested as of July 2, 2016 were converted into 9,552 RSUs of the Issuer vesting in five equal annual installments beginning on May 15, 2017.
Daniel B. Kim, as attorney-in-fact
2021-05-17