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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option (Right-to-Buy) | $ 18.625 | 08/08/1988(2) | 12/07/2010 | Common Stock | 9,988 | 9,988 | D | ||||||||
Employee Stock Option (Right-to-Buy) | $ 25.95 | 08/08/1988(3) | 01/17/2012 | Common Stock | 7,684 | 7,684 | D | ||||||||
Employee Stock Option (Right-to-Buy) | $ 27.9 | 08/08/1988(4) | 12/09/2012 | Common Stock | 7,022 | 7,022 | D | ||||||||
Phantom Units | $ 0 (5) | 08/08/1988(6) | 08/08/1988(6) | Common Stock | 1,569.99 | 1,569.99 (9) | D | ||||||||
Employee Stock Option (Right-to-Buy) | $ 27.3 | 08/08/1988(7) | 12/03/2013 | Common Stock | 7,622 | 7,622 | D | ||||||||
Employee Stock Option (Right-to-Buy) | $ 28.98 | 08/08/1988(8) | 12/02/2014 | Common Stock | 9,174 | 9,174 | D | ||||||||
Phantom Units | $ 0 (10) | 05/20/2005 | A | 13.83 | 08/08/1988(11) | 08/08/1988(11) | Common Stock | 13.83 | $ 31.3 | 47.72 (12) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MCCREARY JAMES C 1200 WILLOW LAKE BOULEVARD P.O. BOX 64683 ST. PAUL 55164-0683 |
VP, Corporate Controller |
Timothy J. Keenan, Attorney-in-Fact | 05/24/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | 401(k) Plan: This amount includes shares and dividends acquired during the fiscal year pursuant to the H.B. Fuller Company Thrift Plan. |
(2) | 2000 Stock Incentive Plan: This option vests in four equal installments beginning on December 7, 2001. |
(3) | 2000 Stock Incentive Plan: This option vests in four equal installments beginning on January 17, 2003. |
(4) | 2000 Stock Incentive Plan: This option vests in four equal installments beginning on December 9, 2003. |
(5) | Deferred Compensation Plan: These units convert into shares of common stock on a 1-for-1 basis. |
(6) | Deferred Compensation Plan: Units convert into shares of common stock upon the earlier of certain termination events as specified in the Key Employee Deferred Compensation Plan or such earlier date as selected by the participant. |
(7) | 2000 Stock Incentive Plan: This option vests in four equal installment beginning on December 3, 2004. |
(8) | 2000 Stock Incentive Plan: This option vests in four equal installments beginning on December 2, 2005. |
(9) | Key Employee Deferred Compensation Plan Dividend Reinvestment: This amount includes stock units acquired pursuant to a dividend equivalent feature of the Key Employees' Deferred Compensation Plan. |
(10) | Deferred Compensation Plan: These units (acquired after 12-31-04) convert into shares of common stock on a 1-for-1 basis. |
(11) | Deferred Compensation Plan: These units (acquired after 12-31-04) convert into shares of common stock upon the earlier of certain termination events as specified in the Key Employee Deferred Compensation Plan or such earlier date as selected by the participant, subject to holding periods required by law. |
(12) | Key Employee Deferred Compensation Plan Dividend Reinvestment: This amount (acquired after 12-31-04) includes stock units acquired pursuant to a dividend equivalent feature of the Key Employees' Deferred Compensation Plan. |
(13) | 2000 Stock Incentive Plan: These restricted shares were awarded pursuant to H.B. Fuller Company's 2000 Stock Incentive Plan. Amount includes 893 restricted shares that vest in four equal annual installments beginning on April 15, 2005, and 2237 restricted shares that vest effective December 2, 2007. Total amount also includes restricted shares acquired pursuant to a dividend reinvestment feature of the 2000 Stock Incentive Plan. |