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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) | $ 24.87 | (3) | 12/01/2021 | Common Stock | 2,940 | 2,940 | D | ||||||||
Stock Option (right to buy) | $ 38.14 | (4) | 11/02/2018 | Common Stock (4) | (4) | 2,040 | D | ||||||||
Stock Option (right to buy) | $ 49.45 | (5) | 12/31/2019 | Common Stock (5) | (5) | 3,857 | D | ||||||||
Stock Option (right to buy) | $ 17 | (6) | 12/12/2020 | Common Stock | 4,545 | 4,545 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Boehm Rosanne TWO RUAN CENTER 601 LOCUST STREET, 14TH FLOOR DES MOINES, IA 50309 |
SVP, Human Resources |
/s/ Erica Fine, Attorney-in-fact | 12/14/2016 | |
**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 the withholding by the Issuer of restricted stock to satisfy the reporting person's tax withholding obligations upon the vesting of restricted stock, which has been approved pursuant to the requirements of Rule 16b-3. |
(2) | Includes restricted stock. |
(3) | The option vests in three equal annual installments on December 1, 2015, 2016 and 2017, subject to continued employment through such date. |
(4) | The option entitles the reporting person to receive, upon exercise, a cash payment equal to the excess of the fair market value of a share of Class A Common Stock of F&G Subsidiary, over the exercise price of the option. It is expected that the fair market value of a share of Class A Common Stock of the F&G Subsidiary will be derived from the value of the Common Stock of the Issuer. The option became exercisable as to 1,013 shares on November 2, 2012, 1,014 shares on November 2, 2013, and 1,013 shares on November 2, 2014. |
(5) | The option entitles the reporting person to receive, upon exercise, a cash payment equal to the excess of the fair market value of a share of Class B Common Stock of F&G Subsidiary, over the exercise price of the option. It is expected that the fair market value of a share of Class B Common Stock of the F&G Subsidiary will be derived from the value of the Common Stock of the Issuer. The option became exercisable as to 1,286 shares on December 31, 2013, 1,285 shares on December 31, 2014, and 1,286 shares on December 31, 2015. |
(6) | The option vests in three equal annual installments on December 12, 2014, 2015 and 2016, subject to continued employment through such date. |