Initial Statement of Beneficial Ownership (3)
April 04 2019 - 12:21PM
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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Miebach Michael
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2. Date of Event Requiring Statement (MM/DD/YYYY)
4/1/2019
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3. Issuer Name
and
Ticker or Trading Symbol
Mastercard Inc [MA]
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(Last)
(First)
(Middle)
2000 PURCHASE STREET
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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)
Chief Product Officer /
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(Street)
PURCHASE, NY 10577
(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)
_
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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Class A Common Stock
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17781
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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 ro buy)
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(1)
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3/1/2025
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Class A Common Stock
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5422.0
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$90.13
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D
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Employee Stock Option (right ro buy)
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(2)
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3/1/2026
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Class A Common Stock
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25230.0
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$90.1
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D
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Employee Stock Option (right ro buy)
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(3)
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3/1/2027
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Class A Common Stock
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47104.0
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$112.31
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D
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Employee Stock Option (right ro buy)
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(4)
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3/1/2028
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Class A Common Stock
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29952.0
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$173.49
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D
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Employee Stock Option (right ro buy)
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(5)
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3/1/2029
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Class A Common Stock
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26400.0
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$227.25
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D
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Explanation of Responses:
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(1)
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The reporting person was awarded employee stock options on March 1, 2015, of which 5,422 remain and are fully vested.
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(2)
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The reporting person was awarded 33,640 employee stock options on March 1, 2016, of which 25,230 have vested. The remaining 8,410 employee stock options will vest on March 1, 2020.
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(3)
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The reporting person was awarded 47,104 employee stock options on March 1, 2017, of which 23,552 have vested. The remaining 23,552 employee stock options will vest in two equal annual installments beginning on March 1, 2020.
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(4)
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The reporting person was awarded 29,952 employee stock options on March 1, 2018, of which 7,488 have vested. The remaining 22,464 employee stock options will vest in three equal annual installments beginning on March 1, 2020.
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(5)
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The reporting person was awarded 26,400 employee stock options on March 1, 2019 which will vest in four (4) equal annual installments beginning March 1, 2020.
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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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Miebach Michael
2000 PURCHASE STREET
PURCHASE, NY 10577
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Chief Product Officer
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Signatures
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Craig Brown, as attorney-in-fact for Michael Miebach, pursuant to a power of attorney dated March 19, 2019
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4/4/2019
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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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