0001631148-17-000041.txt : 20171004 0001631148-17-000041.hdr.sgml : 20171004 20171004155050 ACCESSION NUMBER: 0001631148-17-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171002 FILED AS OF DATE: 20171004 DATE AS OF CHANGE: 20171004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Watza David Lawrence CENTRAL INDEX KEY: 0001655189 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20206 FILM NUMBER: 171121553 MAIL ADDRESS: STREET 1: 47827 HALYARD DRIVE 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 2017-10-02 0000887226 PERCEPTRON INC/MI PRCP 0001655189 Watza David Lawrence 47827 HALYARD DRIVE PLYMOUTH MI 48170 0 1 0 0 President, CEO and CFO Common Stock 2017-10-02 4 A 0 8200 0.00 A 22892 D Employee Stock Option (right to buy) 7.95 2017-10-02 4 A 0 100000 0 A 2027-10-02 Common Stock 100000 100000 D On October 2, 2017, the reporting person was granted 8,200 restricted stock units under the 2004 Stock Incentive Plan, an exempt plan. Each restricted stock unit represents a contingent right to receive one share of Common Stock of the Issuer. Provided the reporting person remains employed with the Issuer on each of the relevant dates, the units will vest as follows: 2,733 units will vest on the first anniversary of the grant date; 2,733 units will vest on the second anniversary of the grant date; 2,734 units On October 2, 2017, the reporting person was granted an option to purchase 100,000 shares of Common Stock under the 2004 Stock Incentive Plan, an exempt plan. The shares are exercisable in three equal annual installments beginning October 2, 2018 at the exercise price equal to the fair market value of the Company's Common Stock as of October 2, 2017, expiring ten years from the grant date. Michelle O. Wright on behalf of David Lawrence Watza 2017-10-04