0001225208-18-013054.txt : 20180904 0001225208-18-013054.hdr.sgml : 20180904 20180904162717 ACCESSION NUMBER: 0001225208-18-013054 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180831 FILED AS OF DATE: 20180904 DATE AS OF CHANGE: 20180904 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MITAU LEE R CENTRAL INDEX KEY: 0001185489 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09225 FILM NUMBER: 181052662 MAIL ADDRESS: STREET 1: P O BOX 1441 CITY: MINNEAPOLIS STATE: MN ZIP: 55440-1441 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 2018-08-31 0000039368 FULLER H B CO FUL 0001185489 MITAU LEE R 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL MN 55164-0683 1 Common Stock 42672.7400 D Common Stock 100.0000 I By Daughter Stock Units 0.0000 2018-08-31 4 A 0 829.9700 56.9900 A Common Stock 829.9700 112639.4600 D Stock Units 0.0000 1988-08-08 Common Stock 46909.0600 46909.0600 D These units convert into shares of common stock on a 1-for-1 basis. These units will be converted into shares of common stock upon retirement, death, disability or certain specified events, all as defined in such plan, subject to holding periods required by law. This amount includes stock units acquired pursuant to a dividend equivalent feature of the Directors' Deferred Compensation Plan. These units (acquired before 12-31-04) will be converted into shares of common stock upon retirement, death, disability or certain specified events, all as defined in such plan, subject to holding periods required by law. /s/ Timothy J. Keenan, Attorney-in-Fact 2018-09-04