0001631148-17-000033.txt : 20170911 0001631148-17-000033.hdr.sgml : 20170911 20170911161055 ACCESSION NUMBER: 0001631148-17-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170907 FILED AS OF DATE: 20170911 DATE AS OF CHANGE: 20170911 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Van Valkenburg Richard CENTRAL INDEX KEY: 0001715675 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20206 FILM NUMBER: 171079115 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 4 1 certent-form4.xml PRIMARY DOCUMENT X0306 4 2017-09-07 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 2017-09-07 4 A 0 5826 7.34 A 7589 D Common Stock 20000 I By spouse On September 7, 2017, the reporting person was granted 5,826 shares of Common Stock as a restricted stock award under the 2004 Stock Incentive Plan, an exempt plan. 1,457 shares will vest on grant date. Provided the reporting person remains employed with the Issuer on each of the relevant dates, the remaining shares will vest as follows: 1,457 shares will vest on the first anniversary of the grant date; 1,456 shares will vest on the second anniversary of the grant date; 1,456 shares will vest on the third anniversary of the grant date. 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. Michelle O. Wright on behalf of Richard Van Valkenburg 2017-09-11