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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 | ||||||||
Option - right to buy (2) | $ 14.08 | 03/13/2013 | 03/13/2013 | M | 302 | 06/06/2006 | 06/06/2013 | Common Stock | 10,000 | $ 0 | 6,800 | D | |||
Option - right to buy (2) | $ 20.68 | 03/13/2013 | 03/13/2013 | M | 5,000 | 07/05/2010 | 07/05/2015 | Common Stock | 10,000 | $ 0 | 0 | D | |||
Option - right to buy (2) | $ 26.92 | 06/25/2010 | 06/25/2017 | Common Stock | 10,000 | 10,000 | D | ||||||||
Option - right to buy (2) | $ 25.26 | 06/23/2012 | 06/23/2019 | Common Stock | 20,000 | 20,000 | D | ||||||||
Option - right to buy (4) | $ 44.39 | 06/23/2014 | 06/23/2021 | Common Stock | 20,000 | 20,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Walljasper William J ONE CONVENIENCE BLVD. PO BOX 3001 ANKENY, IA 50021 |
Senior VP and CFO |
William J. Noth, under power of attorney dated 8/16/04 | 03/14/2013 | |
**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) | Allocated to Mr. Walljasper's KSOP account as of April 30, 2012. Does not include any shares allocated by KSOP trustee after that date. |
(2) | Pursuant to terms and conditions of 2000 Stock Option Plan |
(3) | Pursuant to terms of 2009 Stock Incentive Plan. This award, which vests in full on May 1, 2014, represents the equity component of the amount payable to Mr. Walljasper under the FY11 annual incentive plan. |
(4) | Pursuant to terms and conditions of 2009 Stock Incentive Plan. |
(5) | Pursuant to terms of 2009 Stock Incentive Plan. This award, which vests in full on May 1, 2015, represents the equity component of the amount payable to Mr. Walljasper under the FY12 annual incentive plan. |
(6) | Consisting of shares acquired upon exercise of stock option. See Table II. |