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Sec Form 4 Filing - Butier Mitchell R @ Avery Dennison Corp - 2017-02-23

  1. About Form 4 Filing: Every director, officer or owner of more than ten percent of a class of equity securities registered under Section 12 of the '34 Act must file with the U.S. Securities and Exchange Commission (SEC) a statement of ownership regarding such security. The initial filing is on Form 3 and changes are reported on Form 4. The Annual Statement of beneficial ownership of securities is on Form 5. The forms contain information on the reporting person's relationship to the company and on purchases and sales of such equity securities.
  2. Form 4 is stored in SEC's EDGAR database. EDGAR is Electronic Data Gathering, Analysis and Retrieval System. It is a registered trademark of the SEC.

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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
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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1. Name and Address of Reporting Person *
Butier Mitchell R
2. Issuer Name and Ticker or Trading Symbol
Avery Dennison Corp [ AVY]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
President and CEO
(Last)
(First)
(Middle)
207 GOODE AVENUE
3. Date of Earliest Transaction (MM/DD/YY)
02/23/2017
(Street)
GLENDALE, CA91203
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City)
(State)
(Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/23/2017 M 6,301 A $ 80.21 84,351 D
Common Stock 02/23/2017 F 3,288 D $ 80.21 81,063 D
Common Stock 02/23/2017 M 6,252 A $ 80.21 87,315 D
Common Stock 02/23/2017 F 2,349 D $ 80.21 84,966 D
Common Stock 02/23/2017 M 10,073 A $ 80.21 95,039 D
Common Stock 02/23/2017 F 4,369 D $ 80.21 90,670 D
Common Stock 02/23/2017 M 9,481 A $ 80.21 100,151 D
Common Stock 02/23/2017 F 4,948 D $ 80.21 95,203 D
Common Stock 02/23/2017 M 31,140 A $ 80.21 126,343 D
Common Stock 02/23/2017 F 16,250 D $ 80.21 110,093 D
Common Stock (Savings Plan) 3,691.0042 I Savings Plan
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
2013 MSU Award $ 0 02/23/2017 M 6,301 ( 1 ) 02/27/2014 03/01/2017 Common Stock 6,301 $ 0 0 D
2014 MSU Award $ 0 02/23/2017 M 6,252 ( 2 ) 02/26/2015 02/27/2018 Common Stock 6,252 $ 0 3,725 D
2015 MSU Award $ 0 02/23/2017 M 10,073 ( 3 ) 02/26/2016 02/26/2019 Common Stock 10,073 $ 0 12,572 D
2016 MSU Award $ 0 02/23/2017 M 9,481 ( 4 ) 02/25/2017 02/25/2020 Common Stock 9,481 $ 0 22,627 D
2014 PU Award $ 0 02/23/2017 M 31,140 ( 5 ) 02/27/2017 02/27/2017 Common Stock 31,140 $ 0 0 D
2017 MSU Award $ 0 02/23/2017 A 25,574 ( 6 ) 02/23/2018 02/23/2021 Common Stock 25,574 $ 0 25,574 D
2017 PU Award $ 0 02/23/2017 A 29,452 ( 7 ) 02/23/2020 02/23/2020 Common Stock 29,452 $ 0 29,452 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Butier Mitchell R
207 GOODE AVENUE
GLENDALE, CA91203
X President and CEO
Signatures
/s/ Erica Perry POA for Mitchell R Butier 02/27/2017
** Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares reflect the vesting of the fourth tranche of market leveraged stock units granted in February 2013 at 200% of target based on our absolute total shareholder return during 2013-2016, plus dividend equivalents accrued during the period.
( 2 )Shares reflect the vesting of the third tranche of market leveraged stock units granted in February 2014 at 156% of target based on our absolute total shareholder return during 2014-2016, plus dividend equivalents accrued during the period.
( 3 )Shares reflect the vesting of the second tranche of market leveraged stock units granted in February 2015 at 153% of target based on our absolute total shareholder return in excess of 10% during 2015-2016, plus dividend equivalents accrued during the period.
( 4 )Shares reflect the vesting of the first tranche of market leveraged stock units granted in February 2016 at 123% of target based on our absolute total shareholder return in excess of 10% during 2016, plus dividend equivalents accrued during the period.
( 5 )Shares reflect the vesting of performance units granted in February 2014 at 200% of target, 50% based on our cumulative economic value added and 50% on our relative total shareholder return performance objectives established for the award.
( 6 )Market leveraged stock units vest 25% over one-, two-, three- and four-year performance periods using a conversion formula under which the number of shares earned at each vesting date is based on the Company's absolute total shareholder return, plus dividend equivalents accrued during the vesting period. Each marked leveraged stock unit represents a contingent right to receive one share of Avery Dennison Corporation common stock, plus dividend equivalents.
( 7 )Performance units vest, if at all, at the end of fiscal year 2019, provided certain Company performance objectives are met as determined in February 2020.? Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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