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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
STOCK UNITS (2) | (2) | 02/12/2016 | J(3) | 100 | (2) | (2) | COMMON STOCK | 100 | $ 50 | 8,779.1907 | D | ||||
STOCK UNITS (RSDCP) (4) | (4) | (4) | (4) | COMMON STOCK | 10,466.8009 | 10,466.8009 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Luiz Kaufmann 777 106TH AVENUE NE BELLEVUE, WA 98004 |
X |
Luiz Kaufmann by Michael K. Walton POA | 02/16/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Shares held by the company Villamil Group Inc which is 100% controlled by the Reporting Person. |
(2) | Stock units held in deferred phantom stock account under PACCAR Restricted Stock and Deferred Compensation Plan for non-Employee Directors (RSDCP) convertible to common stock on a 1 - for - 1 basis upon termination of the Reporting Person's status as a non-employee director. |
(3) | Cash compensation deferred into phantom stock account under RSDCP. |
(4) | Restricted stock units held in deferred phantom stock account under RSDCP convertible to PACCAR common stock on a 1-for-1 basis upon satisfaction of all applicable vesting conditions. |