0001225208-19-001356.txt : 20190128 0001225208-19-001356.hdr.sgml : 20190128 20190128162445 ACCESSION NUMBER: 0001225208-19-001356 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190124 FILED AS OF DATE: 20190128 DATE AS OF CHANGE: 20190128 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: 19545739 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: 1201 BUSINESS ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 BUSINESS PHONE: 6126453401 MAIL ADDRESS: STREET 1: 1200 WILLOW LAKE BLVD CITY: ST PAUL STATE: MN ZIP: 55110-5132 4 1 doc4.xml X0306 4 2019-01-24 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 3416.0000 D Employee Stock Option (Right-to-Buy) 45.0500 2019-01-24 4 A 0 19230.0000 45.0500 A 2020-01-24 2029-01-24 Common Stock 19230.0000 19230.0000 D Performance Stock Units 0.0000 2019-01-24 4 A 0 2063.0000 0.0000 A 2020-01-24 2022-01-24 Common Stock 2063.0000 2063.0000 D Restricted Stock Units 0.0000 2019-01-24 4 A 0 1086.0000 0.0000 A 2020-01-24 2020-01-24 Common Stock 1086.0000 1086.0000 D Restricted Stock Units 0.0000 2019-01-24 4 A 0 2063.0000 0.0000 A 2020-01-24 2022-01-24 Common Stock 2063.0000 2063.0000 D Employee Stock Option (Right-to-Buy) 33.3800 2017-01-19 2026-01-19 Common Stock 22374.0000 22374.0000 D Employee Stock Option (Right-to-Buy) 34.4300 2016-10-01 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 Employee Stock Option (Right-to-Buy) 53.5700 2019-01-25 2028-01-25 Common Stock 16375.0000 16375.0000 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 2019-01-25 2021-01-25 Common Stock 1745.7400 1745.7400 D Performance Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 1307.2000 1307.2000 D Restricted Stock Units 0.0000 2019-01-25 2021-01-25 Common Stock 1745.7400 1745.7400 D Restricted Stock Units 0.0000 2018-01-26 2020-01-26 Common Stock 2950.9900 2950.9900 D This option vests in three equal annual installments beginning on the date shown. These performance stock units convert into shares of common stock on a 1-for-1 basis. Each performance stock unit represents a contingent right to receive one share of H.B. Fuller common stock. Prior to vesting, the number of units subject to the award will be adjusted based on the company's return on invested capital performance for the applicable year. The number of units may increase to as much as 200% or decrease as low as 0% of the initial number of units depending on the level of ROIC performance. The grant amount is shown at a target level of performance. 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. These restricted stock units convert into shares of common stock on a 1-for-1 basis. These restricted stock units vest in one annual installment on the date shown. These restricted stock units vest in three equal annual installments beginning on the date shown. This option is 100% vested. 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. Amount includes performance stock units acquired pursuant to a dividend equivalent reinvestment feature. 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 restricted stock units acquired pursuant to a dividend equivalent reinvestment feature. /s/ Timothy J. Keenan, Attorney-in-Fact 2019-01-28