0001225208-17-015846.txt : 20171003 0001225208-17-015846.hdr.sgml : 20171003 20171003185247 ACCESSION NUMBER: 0001225208-17-015846 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171001 FILED AS OF DATE: 20171003 DATE AS OF CHANGE: 20171003 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kivits Patrick M. CENTRAL INDEX KEY: 0001653265 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 171119865 MAIL ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD. STREET 2: P.O. BOX 64683 CITY: ST. PAUL STATE: MN ZIP: 55110 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FULLER H B CO CENTRAL INDEX KEY: 0000039368 STANDARD INDUSTRIAL CLASSIFICATION: ADHESIVES & SEALANTS [2891] IRS NUMBER: 410268370 STATE OF INCORPORATION: MN FISCAL YEAR END: 1203 BUSINESS ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 BUSINESS PHONE: 6126453401 4 1 doc4.xml X0306 4 2017-10-01 0000039368 FULLER H B CO FUL 0001653265 Kivits Patrick M. 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Senior VP, EIMEA Common Stock 2017-10-01 4 M 0 622.0000 58.0600 A 667.0000 D Common Stock 2017-10-01 4 F 0 324.0000 58.0600 D 343.0000 D Restricted Stock Units 0.0000 2017-10-01 4 M 0 622.0000 58.0600 D 2018-10-01 Common Stock 622.0000 642.8600 D Employee Stock Option (Right-to-Buy) 33.3800 2026-01-19 Common Stock 22374.0000 22374.0000 D Employee Stock Option (Right-to-Buy) 34.4300 2025-10-01 Common Stock 7207.0000 7207.0000 D Employee Stock Option (Right-to-Buy) 50.1000 2018-01-26 2027-01-26 Common Stock 17772.0000 17772.0000 D Performance Stock Units 0.0000 2017-01-19 2019-01-19 Common Stock 1751.6900 1751.6900 D Performance Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 1921.5200 1921.5200 D Restricted Stock Units 0.0000 2019-01-19 Common Stock 1752.6900 1752.6900 D Restricted Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 4339.3100 4339.3100 D Shares withheld for taxes due on 622 shares issued. H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units convert into shares of common stock on a 1-for-1 basis. H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on October 1, 2016. H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units include stock units acquired pursuant to a dividend equivalent reinvestment feature of the H.B. Fuller Company 2013 Master Incentive Plan. H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal installments beginning on January 19, 2017. This option makes up part of the reporting person's fiscal year 2016 long-term incentive plan grant. H.B. Fuller Company 2013 Master Incentive Plan: This option vests in three equal annual installments beginning on October 1, 2016. H.B. Fuller Company 2016 Master Incentive Plan: This option vests in three equal installments beginning on the date shown. H.B. Fuller Company 2013 Master Incentive Plan: These performance stock units convert into shares of common stock on a 1-for-1 basis. H.B. Fuller Company 2013 Master Incentive Plan: These performance stock units vest in three annual installments beginning on the date shown upon H.B. Fuller achieving return on invested capital at least at the threshold level of performance in each year of the three years of vesting. These performance stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant. H.B. Fuller Company 2016 Master Incentive Plan: These performance stock units convert into shares of common stock on a 1-for-1 basis. H.B. Fuller Company 2016 Master Incentive Plan: These performance stock units vest in three annual installments beginning on the date shown upon H.B. Fuller achieving return on invested capital at least at the threshold level of performance in each year of the three years of vesting. H.B. Fuller Company 2013 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on January 19, 2017. These restricted stock units make up part of the reporting person's fiscal year 2016 long-term incentive plan grant. H.B. Fuller Company 2016 Master Incentive Plan: These restricted stock units convert into shares of common stock on a 1-for-1 basis. H.B. Fuller Company 2016 Master Incentive Plan: These restricted stock units vest in three equal annual installments beginning on the date shown. /s/ Timothy J. Keenan, Attorney-in-Fact 2017-10-03