Initial Statement of Beneficial Ownership (3)
July 10 2017 - 4:03PM
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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Fleet Peter D.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
7/1/2017
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3. Issuer Name
and
Ticker or Trading Symbol
FORD MOTOR CO [F]
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(Last)
(First)
(Middle)
ONE AMERICAN ROAD
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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)
Group Vice President /
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(Street)
DEARBORN, MI 48126
(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, $0.01 par value
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7403
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D
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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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Employee Stock Option (Right to Buy)
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(1)
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3/2/2021
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Common Stock, $0.01 par value
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7488
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$14.76
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D
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Employee Stock Option (Right to Buy)
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(2)
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3/4/2022
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Common Stock, $0.01 par value
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14579
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$12.46
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D
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Employee Stock Option (Right to Buy)
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(3)
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3/3/2023
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Common Stock, $0.01 par value
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16411
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$12.75
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D
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Employee Stock Option (Right to Buy)
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(4)
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3/3/2024
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Common Stock, $0.01 par value
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13510
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$15.37
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D
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Ford Stock Units
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(5)
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(5)
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Common Stock, $0.01 par value
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1617
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(5)
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D
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Ford Stock Units
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(6)
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(6)
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Common Stock, $0.01 par value
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8412
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(6)
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D
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Ford Stock Units
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(7)
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(7)
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Common Stock, $0.01 par value
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15402
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(7)
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D
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Explanation of Responses:
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(1)
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This option became exercisable to the extent of 33% of the shares optioned after one year from the date of grant (03/03/2011), 66% after two years, and in full after three years.
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(2)
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This option became exercisable to the extent of 33% of the shares optioned after one year from the date of grant (03/05/2012), 66% after two years, and in full after three years.
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(3)
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This option became exercisable to the extent of 33% of the shares optioned after one year from the date of grant (03/04/2013), 66% after two years, and in full after three years.
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(4)
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This option became exercisable to the extent of 33% of the shares optioned after one year from the date of grant (03/04/2014), 66% after two years, and in full after three years.
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(5)
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These Ford Restricted Stock Units were acquired under the Company's 2008 Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, in shares of Common Stock on March 4, 2018.
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(6)
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These Ford Restricted Stock Units were acquired under the Company's 2008 Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 4,143 shares Common Stock on March 3, 2018 and 4,269 shares of Common Stock on March 3, 2019.
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(7)
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These Ford Restricted Stock Units were acquired under the Company's 2008 Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, in shares of Common Stock to the extent of 33% after one year from the date of grant (03/02/2017), 66% after two years, and in full after three years.
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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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Fleet Peter D.
ONE AMERICAN ROAD
DEARBORN, MI 48126
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Group Vice President
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Signatures
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Jerome F. Zaremba,
Attorney-in-Fact
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7/10/2017
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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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