0000048287-21-000145.txt : 20211210 0000048287-21-000145.hdr.sgml : 20211210 20211210091502 ACCESSION NUMBER: 0000048287-21-000145 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211208 FILED AS OF DATE: 20211210 DATE AS OF CHANGE: 20211210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WATERS RONALD V CENTRAL INDEX KEY: 0001163222 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14225 FILM NUMBER: 211483844 MAIL ADDRESS: STREET 1: 75 EAST ELM STREET CITY: CHICAGO STATE: IL ZIP: 60611 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HNI CORP CENTRAL INDEX KEY: 0000048287 STANDARD INDUSTRIAL CLASSIFICATION: OFFICE FURNITURE (NO WOOD) [2522] IRS NUMBER: 420617510 STATE OF INCORPORATION: IA FISCAL YEAR END: 0101 BUSINESS ADDRESS: STREET 1: 600 EAST SECOND STREET - PO BOX 1109 CITY: MUSCATINE STATE: IA ZIP: 52761-7109 BUSINESS PHONE: 5632727400 MAIL ADDRESS: STREET 1: 600 EAST SECOND STREET STREET 2: P O BOX 1109 CITY: MUSCATINE STATE: IA ZIP: 52761 FORMER COMPANY: FORMER CONFORMED NAME: HON INDUSTRIES INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: HOME O NIZE CO DATE OF NAME CHANGE: 19681001 4 1 wf-form4_163914568888213.xml FORM 4 X0306 4 2021-12-08 0 0000048287 HNI CORP HNI 0001163222 WATERS RONALD V 600 EAST SECOND STREET MUSCATINE IA 52761 1 0 0 0 Common Stock 2021-12-08 5 G 0 E 1300 0 D 36673.7406 D Common Stock 2021-12-08 5 G 0 E 10630 0 D 26289.9074 D Common Stock 2021-12-08 5 G 0 E 10630 0 A 10630 I By Trust These shares were gifted to Joffrey Ballet of Chicago. These shares were transferred into a legacy trust for the benefit of the reporting person's spouse. The total in column 5 includes reinvested dividends of 246.1668 shares acquired under the Corporation's 2017 Equity Plan for Non-Employee Directors since the reporting person's last report, which acquisitions are exempt from Section 16. These shares are held in trust for the benefit of the reporting person's spouse. The reporting person's spouse is trustee of the trust. The reporting person disclaims beneficial ownership of these shares, and the filing of this report is not an admission that the reporting person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose. /s/ Steven M. Bradford, By Power of Attorney 2021-12-10