0001225208-20-006105.txt : 20200406 0001225208-20-006105.hdr.sgml : 20200406 20200406121052 ACCESSION NUMBER: 0001225208-20-006105 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200402 FILED AS OF DATE: 20200406 DATE AS OF CHANGE: 20200406 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: 20776361 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: 1128 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 2020-04-02 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 2020-04-02 4 J 0 42671.0000 0.0000 A 42671.0000 I By GRAT Common Stock 100.0000 I By Daughter Stock Units 0.0000 Common Stock 123746.0800 123746.0800 D Stock Units 0.0000 1988-08-08 Common Stock 47863.2700 47863.2700 D On April 2, 2020, the reporting person withdrew 42,671 shares of H.B. Fuller common stock from a grantor retained annuity trust established for the benefit of himself, his adult children and their descendants. In exchange for the shares, the reporting person contributed to the trust bonds and cash in the principal amount of $1,113,073.00. The reporting person believes that his withdrawal of shares from the trust, and their subsequent contribution into anew grantor retained annuity trust, constitute a change in form of beneficial ownership of the shares, exempted by Rule 16a-13 under the Securities Exchange Act of 1934. 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 2020-04-06