0001014108-21-000169.txt : 20210830 0001014108-21-000169.hdr.sgml : 20210830 20210830154824 ACCESSION NUMBER: 0001014108-21-000169 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210827 FILED AS OF DATE: 20210830 DATE AS OF CHANGE: 20210830 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bertelsen Jeffrey A. CENTRAL INDEX KEY: 0001184340 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16577 FILM NUMBER: 211223437 MAIL ADDRESS: STREET 1: 5900 GOLDEN HILLS DRIVE CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 FORMER NAME: FORMER CONFORMED NAME: BERTELSEN JEFFREY A DATE OF NAME CHANGE: 20020829 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CYBEROPTICS CORP CENTRAL INDEX KEY: 0000768411 STANDARD INDUSTRIAL CLASSIFICATION: OPTICAL INSTRUMENTS & LENSES [3827] IRS NUMBER: 411472057 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5900 GOLDEN HILLS DR CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 BUSINESS PHONE: 763-542-5000 MAIL ADDRESS: STREET 1: 5900 GOLDEN HILLS DR CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-08-27 0 0000768411 CYBEROPTICS CORP CYBE 0001184340 Bertelsen Jeffrey A. 5900 GOLDEN HILLS DRIVE GOLDEN VALLEY MN 55416 0 1 0 0 CFO and COO Common Stock 27444 D Common Stock 2021-08-27 4 M 0 14500 9.62 A 105540 I By Trust Common Stock 2021-08-27 4 F 0 6708 42.62 D 98832 I By Trust Employee Stock Option 9.62 2021-08-27 4 M 0 14500 0 D 2015-12-05 2021-12-05 Common Stock 14500 0 D Employee Stock Option 7.18 2016-12-11 2022-12-11 Common Stock 26000 26000 D Employee Stock Option 26.4 2017-12-09 2023-12-09 Common Stock 5500 5500 D Employee Stock Option 15.4 2018-12-08 2024-12-08 Common Stock 9200 9200 D Employee Stock Option 19.46 2019-12-07 2025-12-07 Common Stock 7400 7400 D Employee Stock Option 16.23 2020-12-06 2026-12-06 Common Stock 10000 10000 D Employee Stock Option 28.32 2021-12-04 2027-12-04 Common Stock 6000 6000 D Shares are held in a revocable trust of which the reporting person and his spouse are trustees. Represents shares surrendered to CyberOptics Corp by the Reporting Person to satisfy the exercise price and tax withholding obligations upon exercise of a stock option granted December 5, 2014. Fully exercisable. Exercisable with respect to 25% of such shares on such date and with respect to an additional cumulative 25% of such shares on the next three anniversaries of such date. /s/ Jeffrey A. Bertelsen 2021-08-30