0001179110-17-014728.txt : 20171130
0001179110-17-014728.hdr.sgml : 20171130
20171130162214
ACCESSION NUMBER: 0001179110-17-014728
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171128
FILED AS OF DATE: 20171130
DATE AS OF CHANGE: 20171130
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: 171231520
MAIL ADDRESS:
STREET 1: 2413 ADVANCE ROAD
CITY: MADISON
STATE: WI
ZIP: 53718
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
4
1
edgar.xml
FORM 4 -
X0306
4
2017-11-28
0
0000815556
FASTENAL CO
FAST
0001555049
Polipnick Gary A.
2413 ADVANCE ROAD
MADISON
WI
53718
0
1
0
0
Executive Vice President
Common Stock
2017-11-28
4
M
0
30000
27
A
91059
D
Common Stock
2017-11-28
4
S
0
30000
50.0287
D
61059
D
Common Stock
7539
I
Held in 401(K) Plan
Employee Stock Option (Right to Buy)
27
2017-11-28
4
M
0
30000
0
D
2018-05-31
Common Stock
30000
0
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.
Shares attributed to reporting person's account within issuer's 401(K) Plan as of November 30, 2017 and includes 292 shares added to this account since the reporting person's last holdings report filed on January 5, 2017.
Includes 1,735 shares maintained in a self-directed IRA.
/s/ John J. Milek, Attorney-in-Fact
2017-11-30