0001209191-21-006855.txt : 20210202
0001209191-21-006855.hdr.sgml : 20210202
20210202172816
ACCESSION NUMBER: 0001209191-21-006855
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210131
FILED AS OF DATE: 20210202
DATE AS OF CHANGE: 20210202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Speetzen Michael T
CENTRAL INDEX KEY: 0001531484
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-11411
FILM NUMBER: 21582847
MAIL ADDRESS:
STREET 1: XYLEM INC.
STREET 2: 1133 WESTCHESTER AVENUE, SUITE N200
CITY: WHITE PLAINS
STATE: NY
ZIP: 10604
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Polaris Inc.
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
FORMER COMPANY:
FORMER CONFORMED NAME: POLARIS INDUSTRIES INC/MN
DATE OF NAME CHANGE: 19941004
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-01-31
0
0000931015
Polaris Inc.
PII
0001531484
Speetzen Michael T
2100 HIGHWAY 55
MEDINA
MN
55340
0
1
0
0
Interim CEO
Common Stock
2021-01-31
4
D
0
3319
D
47808
D
Common Stock
510
I
as UTMA custodian for daughter
Common Stock
510
I
by daughter
Common Stock
510
I
by daughter
Common Stock
510
I
by daughter
Deferred Stock Units
2021-01-31
4
A
0
3319
A
Common Stock
3319
3319
D
Upon the vesting of restricted stock units granted to the reporting person on January 31, 2018, the reporting person deferred the receipt of 3,319 shares of common stock and received instead 3,319 deferred stock units. Each deferred stock unit represents the right to receive one share of the Issuer's common stock.
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.
Each deferred stock unit represents a right to receive one share of the Issuer's common stock, and is received in exchange for one restricted stock unit upon the vesting of such restricted stock unit.
At the settlement date elected by the reporting officer under the Issuer's Supplemental/Retirement Savings Plan ("SERP"), the reporting officer 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
2021-02-02