FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
CERNER CORP /MO/ [ CERN ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 06/28/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 06/28/2017 | G(1) | V | 889,618 | D | $0.00 | 2,009,322 | I | by Spouse as sole Trustee of Irrevocable Trust for children | |
Common Stock | 07/06/2017 | G(2) | V | 11,000,000 | D | $0.00 | 6,620,655 | I | by Revocable Trust | |
Common Stock | 07/06/2017 | G(2) | V | 11,000,000 | A | $0.00 | 11,000,000 | I | by Family Limited Partnership | |
Common Stock | 166,552 | I | by Spouse | |||||||
Common Stock | 116,708 | I | by 401(k) Plan | |||||||
Common Stock | 210,970 | I | by Charitable Remainder Trust | |||||||
Common Stock | 526,230 | I | by Trust as Co-Trustee | |||||||
Common Stock | 1,000,000 | I | by Grantor Retained Annuity Trust |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. This transaction represents the transfer of shares from an irrevocable trust for the benefit of one of the reporting person's children to a revocable trust in which the reporting person has no pecuniary interest. This transaction is exempt from Section 16 pursuant to Rule 16b-5, as it is a bona fide gift. |
2. The reporting person transferred these shares to a family limited partnership of which the reporting person's revocable trust was the sole limited partner and the reporting person shared control over the general partner. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and these shares in this report shall not be deemed an admission of beneficial ownership of all such reported shares. |
Remarks: |
The reporting person passed away on July 9, 2017. |
Shane M. Dawson, by Power of Attorney | 07/28/2017 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |