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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Lane Elizabeth R. 520 LAKE COOK ROAD DEERFIELD, IL 60015 |
SVP-Human Resources |
/s/ Angela M. Pla, Attorney-in-Fact for Elizabeth R. Lane | 02/15/2012 | |
**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) | Represents shares of the issuer's common stock acquired by the reporting person as a result of the settlement of the 2009-2011 performance share awards previously awarded by Fortune Brands, Inc. (n/k/a Beam Inc.). |
(2) | Includes 30,900 unvested restricted stock units which were previously reported on Table II of Form 4 on October 6, 2011. |
(3) | Reflects the withholding by the issuer of shares having a fair market value equal to the withholding taxes due by the reporting person. |
(4) | Represents restricted stock units awarded to the reporting person as a result of the conversion of the 2010-2012 performance share awards previously awarded by Fortune Brands, Inc. (n/k/a Beam Inc.). This conversion occurred pursuant to the terms of the Employee Matters Agreement dated September 28, 2011, between FBHS and Fortune Brands, Inc. Each restricted stock unit represents a contingent right to receive one share of the issuer's common stock. Subject to the reporting person's continued service with the issuer, the restricted stock units shall vest on December 31, 2012. |
(5) | Includes a total of 67,751 restricted stock units that have not yet vested; 30,900 of which were previously reported on Table II of Form 4 on October 6, 2011. |
(6) | Represents the number shares of the issuer's common stock held through participation in the Fortune Brands Home & Security, Inc. Retirement Savings Plan as of February 14, 2012. |