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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 | ||||||||
Director Option (Right to Buy) | $ 14.82 | 01/24/2013 | M | 10,000 | 02/07/2003 | 02/06/2013 | Common Stock | 10,000 | $ 0 | 0 | D | ||||
Phantom Stock (Restricted Stock Units) | (1) | (2) | (2) | Common Stock | 3,164 | 3,164 | D | ||||||||
Phantom Stock (Restricted Stock Units) | (1) | (2) | (2) | Common Stock | 666 | 666 | D | ||||||||
Phantom Stock (Restricted Stock Units) | (1) | (2) | (2) | Common Stock | 448 | 448 | D | ||||||||
Phantom Stock (Restricted Stock Units) | (1) | (2) | (2) | Common Stock | 981 | 981 (3) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
FORTUN WAYNE M 14701 CHARLSON ROAD EDEN PRAIRIE, MN 55347 |
X |
Troy Renner, Attorney-in-Fact for Wayne M. Fortun | 01/28/2013 | |
**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) | Each phantom share/restricted stock unit will be paid in one share of common stock. |
(2) | Following the reporting person's termination of service as a director, vested restricted stock units become payable in shares of common stock according to the schedule previously chosen by the reporting person. |
(3) | Amount shown is the number of performance restricted stock units granted in 2008 that have been subject to a performance period extending from 1/1/2008 to 12/31/12. As of the date of this report, 530 of such performance units have vested, and the remaining 451 performance units are eligible to vest depending on final determination of the company's performance during the final year of the performance period. |