Statement of Changes in Beneficial Ownership (4)
December 08 2016 - 2:48PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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
*
FITZMYERS THOMAS J
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2. Issuer Name
and
Ticker or Trading Symbol
SIMPSON MANUFACTURING CO INC /CA/
[
SSD
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Vice Chairman of the Board
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(Last)
(First)
(Middle)
5956 W. LAS POSITAS BLVD.
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3. Date of Earliest Transaction
(MM/DD/YYYY)
12/7/2016
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(Street)
PLEASANTON, CA 94588
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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12/7/2016
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X
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18000
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A
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$29.66
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118004
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D
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Common Stock
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12/7/2016
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X
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18000
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D
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$46.9824
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100004
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D
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Common Stock (RSUs awarded February 3, 2014)
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2423
(1)
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D
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Common Stock (RSUs awarded February 6, 2013)
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2173
(2)
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D
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Common Stock (RSUs awarded January 30, 2012)
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2923
(3)
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Options on Common Stock
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$29.66
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12/7/2016
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X
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18000
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2/3/2012
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2/3/2018
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Common Stock
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18000.0
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$29.66
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0
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D
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Explanation of Responses:
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(
1)
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Amount includes 2,423 shares of restricted stock units (RSUs) awarded on February 3, 2014. RSUs vest one fourth on each of the award date and the first, second and third anniversaries of the award date. The 2,423 shares are net of the number of shares expected to be withheld to cover the estimated income taxes due on vesting.
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(
2)
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Amount includes 2,173 shares of restricted stock units (RSUs) awarded on February 6, 2013. RSUs vest one fourth on each of the award date and the first, second and third anniversaries of the award date. The 2,173 shares are net of the number of shares expected to be withheld to cover the estimated income taxes due on vesting.
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(
3)
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Amount includes 2,923 shares of restricted stock units (RSUs) awarded on January 30, 2012. RSUs vested one fourth on each of the award date and the first, second and third anniversaries of the award date. Amount was increased by 5 shares to reflect the difference between the number of shares that was expected to be withheld to cover the estimated income taxes due on vesting (estimated on January 30, 2012, the date of the award) and the actual number of shares that was withheld on vesting of the RSUs.
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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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FITZMYERS THOMAS J
5956 W. LAS POSITAS BLVD.
PLEASANTON, CA 94588
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X
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Vice Chairman of the Board
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Signatures
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/s/THOMAS J FITZMYERS
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12/8/2016
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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 4(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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