0001179110-16-018660.txt : 20160205 0001179110-16-018660.hdr.sgml : 20160205 20160205165643 ACCESSION NUMBER: 0001179110-16-018660 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160204 FILED AS OF DATE: 20160205 DATE AS OF CHANGE: 20160205 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: 161392909 MAIL ADDRESS: STREET 1: 2413 ADVANCE ROAD CITY: MADISON STATE: WI ZIP: 53718 4 1 edgar.xml FORM 4 - X0306 4 2016-02-04 0 0000815556 FASTENAL CO FAST 0001555049 Polipnick Gary A. 2413 ADVANCE ROAD MADISON WI 53718 0 1 0 0 Executive Vice President Common Stock 2016-02-04 4 M 0 10000 22.50 A 69324 D Common Stock 2016-02-04 4 S 0 10000 43.54 D 59324 D Common Stock 1735 D Common Stock 1862 I Held in custodian account for Daughter Common Stock 963 I Held in custodian account for Daughter Common Stock 898 I Held by Spouse Common Stock 6965 I Held in 401(K) Plan Employee Stock Option (Right to Buy) 22.50 2016-02-04 4 M 0 10000 0 D 2016-05-31 Common Stock 10000 0 D Employee Stock Option (Right to Buy) 27 2018-05-31 Common Stock 30000 30000 D Employee Stock Option (Right to Buy) 54 2021-05-31 Common Stock 2500 2500 D Employee Stock Option (Right to Buy) 56 2023-05-31 Common Stock 80000 80000 D Employee Stock Option (Right to Buy) 42 2024-05-31 Common Stock 10714 10714 D 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. 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. Reporting person disclaims beneficial ownership of these shares. Shares attributed to reporting person's account within issuer's 401(K) Plan as of February 4, 2016. /s/ John J. Milek, Attorney-in-Fact 2016-02-05