Initial Statement of Beneficial Ownership (3)
June 08 2017 - 03:47PM
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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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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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
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Koback-Pursel Gretchen
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/1/2017
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3. Issuer Name
and
Ticker or Trading Symbol
TIFFANY & CO [TIF]
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(Last)
(First)
(Middle)
200 FIFTH AVENUE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Senior Vice President /
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(Street)
NEW YORK, NY 10010
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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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)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock $.01 Par
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369
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I
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By ESOP
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Common Stock $.01 Par
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849
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I
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By 401(K)
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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)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Restricted Stock Units
(1)
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(2)
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(2)
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Common Stock $.01 Par
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270.0
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(2)
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D
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Restricted Stock Units
(3)
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(4)
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(4)
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Common Stock $.01 Par
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704.0
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(4)
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D
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Restricted Stock Units
(3)
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(5)
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(5)
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Common Stock $.01 Par
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1281.0
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(5)
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D
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Restricted Stock Units
(3)
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(6)
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(6)
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Common Stock $.01 Par
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1108.0
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(6)
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D
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Dividend Equivalent Units
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(7)
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(7)
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Common Stock $.01 Par
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5.0
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(8)
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D
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Restricted Stock Units
(3)
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(9)
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(9)
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Common Stock $.01 Par
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5244.0
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(9)
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D
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Explanation of Responses:
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(1)
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Granted pursuant to the Tiffany & Co. 2005 Employee Incentive Plan, which complies with Rule 16b-3.
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(2)
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The restricted stock units convert to the issuer's common stock on a one-for-one basis and will vest in a single installment on March 19, 2018.
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(3)
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Granted pursuant to the Tiffany & Co. 2014 Employee Incentive Plan, which complies with Rule 16b-3.
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(4)
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The restricted stock units convert to the issuer's common stock on a one-for-one basis and will vest in two equal annual installments on March 18, 2018 and 2019.
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(5)
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The restricted stock units convert to the issuer's common stock on a one-for-one basis and will vest in three equal annual installments on March 16, 2018, 2019 and 2020.
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(6)
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The restricted stock units convert to the issuer's common stock on a one-for-one basis and will vest in four equal annual installments on March 15, 2018, 2019, 2020 and 2021.
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(7)
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The dividend equivalent units will vest proportionately with the underlying restricted stock units to which they relate. The dividend equivalent units credited in respect of the restricted stock units granted on March 15, 2017 will vest in four equal annual installments on March 15, 2018, 2019, 2020 and 2021.
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(8)
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Represents dividend equivalent units accrued on April 10, 2017 in respect of restricted stock units granted to the reporting person on March 15, 2017. The dividend equivalent units convert to the issuer's common stock on a one-for-one basis.
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(9)
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The restricted stock units convert to the issuer's common stock on a one-for-one basis and will vest in four equal annual installments on May 25, 2018, 2019, 2020 and 2021.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Koback-Pursel Gretchen
200 FIFTH AVENUE
NEW YORK, NY 10010
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Senior Vice President
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Signatures
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/s/ Gretchen Koback-Pursel
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6/8/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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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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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.
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