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