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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 | ||||||||
Incentive Stock Option (Right to Buy) (1) | $ 6 | 11/23/2009 | A | 21,383 | 11/23/2010 | 11/23/2016 | Common Stock | 21,383 | $ 0 (1) | 21,383 | D | ||||
Non-qualified Stock Option (Right to Buy) (2) | $ 6 | 11/23/2009 | A | 15,117 | 11/23/2010 | 11/23/2016 | Common Stock | 15,117 | $ 0 (2) | 15,117 | D | ||||
Restricted Stock Units (Time) | (3) | 11/23/2009 | A | 14,600 | 11/23/2012 | (3) | Common Stock | 14,600 | (3) | 14,600 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Hartwell Kimberly Seymour 13625 TECHNOLOGY DRIVE EDEN PRAIRIE, MN 55344 |
VP, Global Go-To-Market |
/s/ Kimberly S. Hartwell | 11/24/2009 | |
**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) | Grant date 11/23/09; incentive stock options that vest as to 4,086 options on each of the first, second and third anniversaries of the date of grant and as to 9,125 options on the fourth anniversary of grant, provided the reporting person remains continuously employed by the company until at least the vesting date. |
(2) | Grant date 11/23/09; non-qualified stock options that vest one-third per year beginning on the first anniversary of the date of grant, provided the reporting person remains continuously employed by the company until at least the vesting date. |
(3) | Time-based restricted stock units issued under the ADC Telecommunications, Inc. 2008 Global Stock Incentive Plan. Subject to certain terms & conditions set forth in the reporting person's Award Agreement, these units will vest upon the third anniversary date of grant and be settled, one-for-one, in shares of common stock, provided the reporting person remains continuously employed by the company until at least the vesting date. |