Statement of Changes in Beneficial Ownership (4)
11 März 2019 - 9:24PM
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
*
LIPPERT JASON
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2. Issuer Name
and
Ticker or Trading Symbol
LCI INDUSTRIES
[
LCII
]
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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)
Chief Executive Officer
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(Last)
(First)
(Middle)
C/O LCI INDUSTRIES, 3501 COUNTY ROAD 6 EAST
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3. Date of Earliest Transaction
(MM/DD/YYYY)
3/7/2019
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(Street)
ELKHART, IN 46514-7663
(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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262714
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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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Performance Stock Unit
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(1)
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3/7/2019
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A
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31646
(2)
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3/7/2022
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3/7/2022
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Common Stock
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31646
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$0
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31646
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D
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Restricted Stock Unit
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(1)
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3/7/2019
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A
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30429
(3)
(4)
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(5)
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(6)
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Common Stock
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30429
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$0
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30429
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D
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Restricted Stock Unit
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(1)
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3/7/2019
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A
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31646
(7)
(4)
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(5)
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(6)
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Common Stock
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31646
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$0
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31646
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D
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Explanation of Responses:
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(1)
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Each Stock Unit represents a contingent right to receive one share of LCII Common Stock.
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(2)
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These Performance Stock Units ("PSUs") represent a contingent right to receive shares of LCII Common Stock, if and to the extent certain Return on Invested Capital and revenue diversification performance goals are achieved in 2021. Earned PSUs, if any, will vest on the date that the registrant's Compensation Committee determines the number of PSUs earned.
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(3)
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These Restricted Stock Units represent a special grant of time-based stock units made in connection with the reporting person's agreement to extend the time period of the restrictive covenants in his employment agreement by an additional 12 months.
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(4)
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These Stock Units vest on March 7 at the rate of one third per year for 3 years.
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(5)
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No exercisable date for this type of award
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(6)
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No expiration date for this type of award
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(7)
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These Restricted Stock Units represent the 2019 annual grant of time-based stock units.
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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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LIPPERT JASON
C/O LCI INDUSTRIES
3501 COUNTY ROAD 6 EAST
ELKHART, IN 46514-7663
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X
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Chief Executive Officer
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Signatures
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/s/ Brian M. Hall on behalf of Jason D. Lippert
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3/11/2019
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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 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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