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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 | ||||||||
Restricted Stock Unit | $ 0 | 07/17/2017 | M | 6,299 | 07/17/2017(2) | (2) | Common | 6,299 | $ 0 | 12,598 | D | ||||
Restricted Stock Unit | $ 0 | 07/17/2017 | J(2) | 12,598 | 07/17/2017(2) | (2) | Common | 12,598 | $ 0 | 0 | D | ||||
Restricted Stock Units | $ 0 | 07/17/2017 | A | 22,883 | 12/29/2017(3) | (3) | Common | 22,883 | $ 0 | 22,883 | D | ||||
Restricted Stock Units | $ 0 | 07/17/2017 | A | 11,638 | 12/29/2017(3) | (3) | Common | 11,638 | $ 0 | 11,638 | D | ||||
Non-Qualified Stock Options | $ 43.7 | 07/17/2017 | A | 67,613 | 12/29/2017(4) | 07/17/2027 | Common | 67,613 | $ 0 | 67,613 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Dziedzic Joseph W 10000 WEHRLE DRIVE CLARENCE, NY 14031 |
X | President & CEO |
/s/ Timothy G. McEvoy as attorney-in-fact for Joseph W. Dziedzic | 07/19/2017 | |
**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 forfeiture of a portion of the restricted stock grant received by Mr. Dziedzic for service as a non-employee director of Integer Holdings Corporation for fiscal 2017 given Mr. Dziedzic's appointment as President & Chief Executive Officer of Integer. |
(2) | Pursuant to the restricted stock award letter dated March 27, 2017, Mr. Dziedzic received a pro-rated vesting based on the term of his service as Interim President and Chief Executive Officer. As a result of his appointment as Chief Executive Officer on July 17, 2017, Mr. Dziedzic received and immediately vested in 6,299 restricted stock units and forfeited the remaining 12,598 of restricted stock units. |
(3) | Grant of restricted stock units that vest in three equal annual installments on the last day of each fiscal year beginning in fiscal year 2017. |
(4) | Grant of non-qualified stock options that vest in three equal annual installments on the last day of each fiscal year beginning in fiscal year 2017. |