Statement of Changes in Beneficial Ownership (4)
16 November 2019 - 1:59AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Miller Charles S. |
2. Issuer Name and Ticker or Trading Symbol
FASTENAL CO
[
FAST
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Executive Vice President |
(Last)
(First)
(Middle)
112 COBBLESTONE LANE |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/13/2019 |
(Street)
WINONA, MN 55987
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 11/13/2019 | | M | | 4376 | A | $27 | 11876 | D | |
Common Stock | 11/13/2019 | | S | | 4376 | D | $35.9772 | 7500 (3) | D | |
Common Stock | | | | | | | | 11680 (4) | I | Held in 401(K) Plan |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Employee Stock Option (Right to Buy) | $27 (2) | 11/13/2019 | | M | | | 4376 (2) | (1) | 5/31/2021 | Common Stock | 4376 (2) | $0 | 624 (2) | D | |
Explanation of Responses: |
(1) | These options will fully vest and become exercisable over a period of eight years, with 50% of the options vesting and becoming exercisable half way through the relevant vesting period and remainder vesting and becoming exercisable proportionately each year thereafter. |
(2) | The option was previously reported in a filing on 12/7/2015 as covering 2500 securities at a strike price of $54, but was adjusted to reflect the stock split on May 22, 2019. |
(3) | On May 22, 2019, the common stock of Fastenal Company split 2-for-1, resulting in the reporting person acquiring an additional 3,750 shares since his last holdings report on 12/13/2018. |
(4) | On May 22, 2019, the common stock of Fastenal Company split 2-for-1, resulting in the reporting person acquiring an additional 5,948 shares from the split and new money since his last holdings report on 12/13/2018. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Miller Charles S. 112 COBBLESTONE LANE WINONA, MN 55987 |
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| Executive Vice President |
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Signatures
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John J. Milek, Attorney-in-Fact | | 11/15/2019 |
**Signature of Reporting Person | Date |
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