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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 | ||||||||
Stock Option (Right to Buy) | $ 19.22 | 10/24/2012 | M | 115,000 | (8) | 05/12/2013 | Common Stock | 115,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 21.15 | 10/24/2012 | M | 115,000 | (9) | 05/25/2014 | Common Stock | 115,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 24.09 | 10/24/2012 | M | 110,000 | (10) | 05/24/2015 | Common Stock | 110,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 36.17 | 10/24/2012 | M | 100,000 | (11) | 05/23/2014 | Common Stock | 100,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 43.62 | 10/24/2012 | M | 125,000 | (12) | 05/08/2015 | Common Stock | 125,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 60.84 | 10/24/2012 | M | 125,000 | (13) | 05/20/2016 | Common Stock | 125,000 | (2) | 0 | D | ||||
Stock Option (Right to Buy) | $ 43.06 | 10/24/2012 | M | 112,500 | (14) | 05/19/2017 | Common Stock | 112,500 | (2) | 37,500 | D | ||||
Stock Option (Right to Buy) | $ 62.23 | 10/24/2012 | M | 55,000 | (15) | 05/25/2018 | Common Stock | 55,000 | (2) | 55,000 | D | ||||
Stock Option (Right to Buy) | $ 66.5 | 10/24/2012 | M | 27,500 | (16) | 05/17/2019 | Common Stock | 27,500 | (2) | 82,500 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MCCAUSLAND PETER C/O AIRGAS, INC. 259 N. RADNOR-CHESTER RD, STE. 100 RADNOR, PA 19087 |
X | X | Executive Chariman | |
MCCAUSLAND BONNIE F ERDENHEIM FARM P.O. BOX 274 LAFAYETTE HILL, PA 19444 |
X |
Robert H. Young, Jr., Attorney-in-Fact for Peter McCausland | 10/26/2012 | |
**Signature of Reporting Person | Date | |
Robert H. Young, Jr., Attorney-in-Fact for Bonnie F. McCausland | 10/26/2012 | |
**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) | Represents shares of Airgas, Inc. common stock distributed to Peter McCausland and Bonnie McCausland (and held jointly) from two separate grantor retained annuity trusts (each, a "GRAT") of which Peter McCausland and Bonnie McCausland are co-trustees and either he or she is a beneficiary. |
(2) | Not applicable. |
(3) | Represents shares of Airgas, Inc. common stock, including shares issued upon the exercise of the stock options reported on Table II herein, jointly owned by Peter McCausland and Bonnie McCausland, except for 15,700 shares that are directly owned by Peter McCausland and indirectly owned by Bonnie McCausland. |
(4) | Represents shares of Airgas, Inc. common stock transfered as a gift from two separate GRATs of which Peter McCausland and Bonnie McCausland are co-trustees and either he or she is a beneficiary. |
(5) | Represents shares of Airgas, Inc. common stock held in two separate GRATs of which Peter McCausland and Bonnie McCausland are co-trustees and either he or she is a beneficiary. |
(6) | The information presented is as of 10/24/2012, the date of the latest available statement of Peter McCausland's holdings of Airgas, Inc. common stock in his 401(k) plan. Since 3/31/2012, the date of the statement relied upon for the amount reported on Peter McCausland's Form 5 dated 5/14/2012, a total of 418 shares of common stock have been acquired in Peter McCausland's 401(k) plan through transactions exempt under Section 16(b). |
(7) | Represents shares of Airgas, Inc. common stock owned directly by Bonnie McCausland and indirectly by Peter McCausland. |
(8) | These options became exercisable in 25% equal increments on each of 5/12/2004, 5/12/2005, 5/12/2006 and 5/12/2007. |
(9) | These options became exercisable in 25% equal increments on each of 5/25/2005, 5/25/2006, 5/25/2007 and 5/25/2008. |
(10) | These options became exercisable in 25% equal increments on each of 5/24/2006, 5/24/2007, 5/24/2008 and 5/24/2009. |
(11) | These options became exercisable in 25% equal increments on each of 5/23/2007, 5/23/2008, 5/23/2009 and 5/23/2010. |
(12) | These options became exercisable in 25% equal increments on each of 5/8/2008, 5/8/2009, 5/8/2010 and 5/8/2011. |
(13) | These options became exercisable in 25% equal increments on each of 5/20/2009, 5/20/2010, 5/20/2011 and 5/20/2012. |
(14) | These options became or will become exercisable, as applicable, in 25% equal increments on each of 5/19/2010, 5/19/2011, 5/19/2012 and 5/19/2013. |
(15) | These options became or will become exercisable, as applicable, in 25% equal increments on each of 5/25/2011, 5/25/2012, 5/25/2013 and 5/25/2014. |
(16) | These options became or will become exercisable, as applicable, in 25% equal increments on each of 5/17/2012, 5/17/2013, 5/17/2014 and 5/17/2015. |