0001209191-16-095361.txt : 20160203 0001209191-16-095361.hdr.sgml : 20160203 20160203170254 ACCESSION NUMBER: 0001209191-16-095361 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160201 FILED AS OF DATE: 20160203 DATE AS OF CHANGE: 20160203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: POLARIS INDUSTRIES INC/MN CENTRAL INDEX KEY: 0000931015 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS TRANSPORTATION EQUIPMENT [3790] IRS NUMBER: 411790959 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2100 HIGHWAY 55 CITY: MEDINA STATE: MN ZIP: 55340 BUSINESS PHONE: (763) 542-0500 MAIL ADDRESS: STREET 1: 2100 HIGHWAY 55 STREET 2: NONE CITY: MEDINA STATE: MN ZIP: 55340 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dougherty Michael D. CENTRAL INDEX KEY: 0001418237 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11411 FILM NUMBER: 161385583 MAIL ADDRESS: STREET 1: 2100 HIGHWAY 55 CITY: MEDINA STATE: MN ZIP: 55340 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-02-01 0 0000931015 POLARIS INDUSTRIES INC/MN PII 0001418237 Dougherty Michael D. 2100 HIGHWAY 55 MEDINA MN 55340 0 1 0 0 President-International Common Stock 8704 D Common Stock 30674 I by spouse's trust Common Stock 1804 I by wife as UTMA custodian for son Common Stock 1825 I by wife as UTMA custodian for daughter Common Stock 4726 I by ESOP Performance Restricted Stock Units 2016-02-01 4 M 0 2752 D 2016-03-15 Common Stock 2752 2752 D Deferred Stock Units 2016-02-01 4 M 0 2752 A Common Stock 2752 8256 D Shares held in a revocable trust of which the reporting person and his spouse are trustees, and the reporting person and his spouse, or other members of their family, are the beneficiaries. Shares held by son who shares reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his son, and this report should not be deemed an admission that the reporting person is the beneficial owner of his son's shares for purposes of Section 16 or for any other purpose. Shares held by daughter who shares reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his daughter, and this report should not be deemed an admission that the reporting person is the beneficial owner of his daughter's shares for purposes of Section 16 or for any other purpose. Estimate of the number of shares held in the reporting person's ESOP fund as of February 1, 2016. This plan uses unit accounting and the number of shares that a participant is deemed to hold varies with the price of Polaris stock. Each performance restricted stock unit represents the right to receive, upon vesting, one share of the Issuer's common stock or, if a deferral election is made, one deferred stock unit under the Issuer's Supplemental/Retirement Savings Plan ("SERP"). Each deferred stock unit represents the right to receive one share of the Issuer's common stock, and is received in exchange for one performance restricted stock unit as described in note 5. At the settlement date elected by the reporting person under the SERP, the reporting person is entitled to receive one share of common stock for each deferred stock unit held. The deferred stock units may be transferred into an alternative investment account in the SERP after a period of six months and one day. Jennifer Carbert, Attorney-in-Fact 2016-02-03