0001225208-17-018854.txt : 20171219 0001225208-17-018854.hdr.sgml : 20171219 20171219132008 ACCESSION NUMBER: 0001225208-17-018854 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171215 FILED AS OF DATE: 20171219 DATE AS OF CHANGE: 20171219 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cai Zhiwei CENTRAL INDEX KEY: 0001666560 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 171263495 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 2017-12-15 0000039368 FULLER H B CO FUL 0001666560 Cai Zhiwei 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Sr. VP, Engineering Adhesives Common Stock 2892.0000 D Phantom Units 0.0000 2017-12-15 4 A 0 4.5500 53.6500 A Common Stock 4.5500 694.5000 D Employee Stock Option (Right-to-Buy) 33.3800 2017-01-19 2026-01-19 Common Stock 9546.0000 9546.0000 D Employee Stock Option (Right-to-Buy) 36.0000 2017-02-12 2026-02-12 Common Stock 6649.0000 6649.0000 D Employee Stock Option (Right-to-Buy) 39.3300 2015-10-01 2024-10-01 Common Stock 1669.0000 1669.0000 D Employee Stock Option (Right-to-Buy) 39.6400 2014-01-24 2023-01-24 Common Stock 2806.0000 2806.0000 D Employee Stock Option (Right-to-Buy) 41.0000 2016-01-22 2025-01-22 Common Stock 7292.0000 7292.0000 D Employee Stock Option (Right-to-Buy) 41.8000 2018-02-02 2025-02-02 Common Stock 27726.0000 27726.0000 D Employee Stock Option (Right-to-Buy) 48.9200 2015-01-23 2024-01-23 Common Stock 2746.0000 2746.0000 D Employee Stock Option (Right-to-Buy) 50.1000 2018-01-26 2027-01-26 Common Stock 13033.0000 13033.0000 D Performance Stock Option (Right-to-Buy) 57.7000 2021-01-31 2027-10-20 Common Stock 62552.0000 62552.0000 D Performance Stock Units 0.0000 2017-01-19 2019-01-19 Common Stock 750.3400 750.3400 D Performance Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 1412.8400 1412.8400 D Performance Stock Units 0.0000 2017-02-12 2019-02-12 Common Stock 521.3900 521.3900 D Restricted Stock Units 0.0000 2017-01-19 2019-01-19 Common Stock 750.3300 750.3300 D Restricted Stock Units 0.0000 2016-01-22 2018-01-22 Common Stock 664.7500 664.7500 D Restricted Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 3589.2600 3589.2600 D Restricted Stock Units 0.0000 2017-02-12 2019-02-12 Common Stock 521.5500 521.5500 D Restricted Stock Units 0.0000 2018-02-12 2020-02-12 Common Stock 20222.4400 20222.4400 D These units (acquired after 12-31-04) convert into shares of common stock on a 1-for-1 basis. These units (acquired after 12-31-04) convert into shares of common stock upon the earlier of certain termination events as specified in the Key Employee DeferredCompensation Plan or such earlier date as selected by the participant, subject to holding periods required by law. Amount includes stock units acquired pursuant to a dividend equivalent feature. This option vests in three equal annual installments beginning on the date shown. This option is 100% vested. This option vests in two equal annual installments beginning on the date shown upon the achievement of certain gross margin targets being met. These performance-based non-qualified stock options vest on the date shown contingent upon H.B. Fuller achieving adjusted EBITDA at least at the threshold level of performance. Each performance-based non-qualified stock option represents a contingent right and option to purchase all or any part of an aggregate of 65,552 shares of Common Stock at the price of $57.70 per share. Prior to vesting, the number of options subject to the award will be adjusted based on the company's adjusted EBITDA performance for fiscal year 2020. The number of options may decrease to as low as 0% of the initial number of options depending on the level of adjusted EBITDA performance. The grant amount is shown at the superior level of performance. These performance stock units convert into shares of common stock on a 1-for-1 basis. These performance stock units vest in three equal 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. This amount has been adjusted to reflect the increase in number of performance stock units of the original grant based on performance criteria. Amount also includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature. Amount includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature. These restricted stock units convert into shares of common stock on a 1-for-1 basis. These restricted stock units vest in three equal annual installments beginning on the date shown. Amount includes restricted stock units acquired pursuant to a dividend equivalent reinvestment feature. /s/ Debra L. Hovland, Attorney-in-Fact 2017-12-19