0001631148-17-000029.txt : 20170907
0001631148-17-000029.hdr.sgml : 20170907
20170907122209
ACCESSION NUMBER: 0001631148-17-000029
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20170830
FILED AS OF DATE: 20170907
DATE AS OF CHANGE: 20170907
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Van Valkenburg Richard
CENTRAL INDEX KEY: 0001715675
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-20206
FILM NUMBER: 171073349
MAIL ADDRESS:
STREET 1: 47827 HALYARD
CITY: PLYMOUTH
STATE: MI
ZIP: 48170
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PERCEPTRON INC/MI
CENTRAL INDEX KEY: 0000887226
STANDARD INDUSTRIAL CLASSIFICATION: OPTICAL INSTRUMENTS & LENSES [3827]
IRS NUMBER: 382381442
STATE OF INCORPORATION: MI
FISCAL YEAR END: 0630
BUSINESS ADDRESS:
STREET 1: 47827 HALYARD DRIVE
CITY: PLYMOUTH
STATE: MI
ZIP: 48170-2461
BUSINESS PHONE: 3134144816
MAIL ADDRESS:
STREET 1: 47827 HALYARD DRIVE
CITY: PLYMOUTH
STATE: MI
ZIP: 48170-2461
3
1
certent-form3.xml
PRIMARY DOCUMENT
X0206
3
2017-08-30
0
0000887226
PERCEPTRON INC/MI
PRCP
0001715675
Van Valkenburg Richard
47827 HALYARD DRIVE
PLYMOUTH
MI
48170
0
1
0
0
V.P Global Sales & Marketing
Common Stock
1763
D
Common Stock
20000
I
By Spouse
Employee Stock Option (right to buy)
5.7
2012-09-04
2022-09-04
Common Stock
375
D
Employee Stock Option (right to buy)
10.55
2013-09-03
2023-09-03
Common Stock
1000
D
Employee Stock Option (right to buy)
6.72
2017-01-03
2027-01-03
Common Stock
20000
D
The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
The option became fully exercisable on September 4, 2016
The option became exercisable as to 250 on each of September 3, 2014, September 3, 2015 and September 3, 2016 and the remaining 250 shares became exercisable on September 3, 2017.
The option becomes exercisable in three equal annual installments beginning January 3,2018.
/s/ Richard Van Valkenburg
2017-09-07
EX-24
2
rickvpowerofattorney.txt
POWEROFATTORNEY
POWER OF ATTORNEY
For Executing Forms 3, 4 and 5
The undersigned hereby constitutes and appoints each of David L. Watza or
Michelle O. Wright, acting singly, as his
true and lawful attorney-in-fact to:
1.execute for and on behalf of the undersigned
Forms 3, 4 and 5 in accordance with Section 16(a)
of the Securities Exchange Act of 1934 and the rules thereunder; and
Securities Exchange Act of 1934 and the rules thereunder; and
2.do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete
the execution of any such Form 3, 4 or 5 and the timely
filing of such form with the United States Securities and
Exchange Commission and any other person or authority.
The undersigned hereby grants to each such attorney-in-fact
full power and authority to do and perform all and every act
and thing whatsoever requisite, necessary and proper to be
done in the exercise of any of the rights and powers
herein granted, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or his substitute or substitutes,
shall lawfully do or cause to be done by virtue
of this power of attorney and the rights and powers herein
granted. The undersigned acknowledges that the
above-named attorneys-in-fact, in serving in such
capacity at the request of the undersigned,
are not assuming any of the undersigneds responsibilities
to comply with Section 16 of the Securities Exchange Act of 1934.
IN WITNESS WHEREOF, the undersigned has caused this
Power of Attorney to be executed as of this 28th day of August 2017.
/s/ Richard J. Van Valkenburg
Signature