Amended Statement of Beneficial Ownership (3/a)
April 22 2020 - 11:10AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0104
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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
*
Weaver Nathan D. |
2. Date of Event Requiring Statement (MM/DD/YYYY)
3/30/2020
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3. Issuer Name and Ticker or Trading Symbol
FULLER H B CO [FUL]
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(Last)
(First)
(Middle)
1200 WILLOW LAKE BOULEVARD, P.O. BOX 64683 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
VP, Human Resources / |
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(Street)
ST. PAUL, MN 55164-0683
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
4/2/2020
| 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 Beneficially Owned
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1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 5949.0000 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Phantom Units | (1) | (1) | Common Stock | 5667.4200 (2) | $0.0000 (3) | D | |
| Explanation of Responses: |
| (1) | These units (acquired after 12-31-04) convert into shares of common stock upon the earlier of certain termination events as specified in the Key Employee Deferred Compensation Plan or such earlier date as selected by the participant, subject to holding periods required by law. |
| (2) | Amount includes stock units acquired pursuant to a dividend equivalent feature. |
| (3) | These units (acquired after 12-31-04) convert into shares of common stock on a 1-for-1 basis. |
Remarks:
This amendment is being filed to correct the amount of securities directly owned by the Reporting Person on Table I. The number reported on the original Form 3 did not include 387 shares recently acquired pursuant to the Key Employee Deferred Compensation Plan. The amendment also corrects the number of Phantom Units reported on Table II by the Reporting Person. The number reported on the original Form 3 did not reflect a recent disposition of 540 units. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Weaver Nathan D.
1200 WILLOW LAKE BOULEVARD
P.O. BOX 64683
ST. PAUL, MN 55164-0683 |
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| VP, Human Resources |
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Signatures
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| /s/ Timothy J. Keenan, Attorney-in-Fact | | 4/22/2020 |
| **Signature of Reporting Person | Date |
H B Fuller (NYSE:FUL)
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