0001179110-21-010077.txt : 20211112 0001179110-21-010077.hdr.sgml : 20211112 20211112105413 ACCESSION NUMBER: 0001179110-21-010077 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211110 FILED AS OF DATE: 20211112 DATE AS OF CHANGE: 20211112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FLORNESS DANIEL L CENTRAL INDEX KEY: 0001017427 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16125 FILM NUMBER: 211401333 MAIL ADDRESS: STREET 1: FASTENAL CO STREET 2: 2001 THEURER BLVD CITY: WINONA STATE: MN ZIP: 55987 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 2021-11-10 0 0000815556 FASTENAL CO FAST 0001017427 FLORNESS DANIEL L 2001 THEURER BOULEVARD WINONA MN 55987 1 1 0 0 CEO and President Common Stock 2021-11-10 4 M 0 99868 23 A 326397 D Common Stock 2021-11-10 4 F 0 66740 58.9243 D 260657 D Common Stock 20000 I By Family Trust Common Stock 9987 I By 401(K) Plan Employee Stock Option (Right to Buy) 23 2021-11-10 4 M 0 99868 0 D 2025-05-31 Common Stock 99868 100000 D These shares are held in a trust for which reporting person's spouse serves as a trustee. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or any other purpose. Shares attributed to reporting person's account within issuer's 401(K) Plan and includes an additional 50 shares acquired since the reporting person's prior holding report filed on 8/12/2021. This transaction consisted of a 'sell to cover' in which the reporting person exercised 99,868 derivative securities (Employee Stock Options) and sold 66,740 optioned shares to pay the cost and taxes associated with acquiring and holding 33,128 optioned shares. The option will fully vest and become exercisable over a period of five years, with 50% of the option 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. /s/ John Milek, Attorney-in-Fact 2021-11-12