0001179110-15-006553.txt : 20150423
0001179110-15-006553.hdr.sgml : 20150423
20150423173212
ACCESSION NUMBER: 0001179110-15-006553
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150421
FILED AS OF DATE: 20150423
DATE AS OF CHANGE: 20150423
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FASTENAL CO
CENTRAL INDEX KEY: 0000815556
STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-BUILDING MATERIALS, HARDWARE, GARDEN SUPPLY [5200]
IRS NUMBER: 410948415
STATE OF INCORPORATION: MN
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2001 THEURER BLVD
CITY: WINONA
STATE: MN
ZIP: 55987
BUSINESS PHONE: 5074545374
MAIL ADDRESS:
STREET 1: 2001 THEURER BLVD
CITY: WINONA
STATE: MN
ZIP: 55987
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Polipnick Gary A.
CENTRAL INDEX KEY: 0001555049
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-16125
FILM NUMBER: 15789431
MAIL ADDRESS:
STREET 1: 2413 ADVANCE ROAD
CITY: MADISON
STATE: WI
ZIP: 53718
4
1
edgar.xml
FORM 4 -
X0306
4
2015-04-21
0
0000815556
FASTENAL CO
FAST
0001555049
Polipnick Gary A.
2413 ADVANCE ROAD
MADISON
WI
53718
0
1
0
0
Executive Vice President
Common Stock
54307
D
Common Stock
1735
D
Common Stock
898
I
Held by Spouse
Common Stock
1796
I
Held in custodian account for Daughter
Common Stock
896
I
Held in custodian account for Daughter
Common Stock
3672
I
By Trust
Common Stock
6660
I
Held by 401(K) Plan
Employee Stock Option (Right to Buy)
42
2015-04-21
4
A
0
10714
0
A
2024-05-31
Common Stock
10714
10714
D
Employee Stock Option (Right to Buy)
56
2023-05-31
Common Stock
80000
80000
D
Employee Stock Option (Right to Buy)
54
2021-05-31
Common Stock
2500
2500
D
Employee Stock Option (Right to Buy)
27
2018-05-31
Common Stock
30000
30000
D
Employee Stock Option (Right to Buy)
22.5
2016-05-31
Common Stock
10000
10000
D
The options will fully vest and become exercisable over a period of five years, with 50% of the options vesting and becoming exercisable half way through the relevant vesting period, and the remainder vesting and becoming exercisable incrementally (20%, 20% and 10%) each year thereafter.
The options will fully vest and become exercisable over a period of eight years, with 50% of the options vesting and becoming exercisable half way through the relevant vesting period, and the remainder vesting and becoming exercisable proportionately each year thereafter.
Shares maintained in self directed IRA account.
Reporting person disclaims beneficial ownership of these shares.
Reporting person's spouse serves as a Trustee of a Trust for the benefit of spouse's sibling.
Shares attributed to reporting person's account with issuer's 401(K) Plan as of April 21, 2015.
/s/ John J. Milek, Attorney-in-Fact
2015-04-23