Initial Statement of Beneficial Ownership (3)
March 15 2017 - 6:50PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
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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
*
Fooks Elik I
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2. Date of Event Requiring Statement (MM/DD/YYYY)
3/13/2017
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3. Issuer Name
and
Ticker or Trading Symbol
ROCKWELL AUTOMATION INC [ROK]
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(Last)
(First)
(Middle)
1201 SOUTH SECOND STREET
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
Senior Vice President /
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(Street)
MILWAUKEE, WI 53204
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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7618.8046
(1)
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D
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Common Stock
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3104.8677
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I
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By savings plan
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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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Employee Stock Option (Right to Buy)
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12/3/2009
(2)
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12/3/2018
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Common Stock
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6000
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$29.37
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D
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Employee Stock Option (Right to Buy)
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12/9/2010
(2)
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12/9/2019
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Common Stock
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10100
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$46.16
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D
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Employee Stock Option (Right to Buy)
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12/7/2011
(2)
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12/7/2020
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Common Stock
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7100
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$69.57
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D
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Employee Stock Option (Right to Buy)
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12/1/2012
(2)
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12/1/2021
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Common Stock
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5200
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$74.14
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D
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Employee Stock Option (Right to Buy)
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12/6/2013
(2)
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12/6/2022
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Common Stock
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4000
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$80.11
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D
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Employee Stock Option (Right to Buy)
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12/4/2014
(2)
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12/4/2023
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Common Stock
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2900
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$108.89
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D
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Employee Stock Option (Right to Buy)
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12/2/2015
(2)
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12/2/2024
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Common Stock
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4300
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$115.69
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D
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Employee stock option (right to buy)
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12/3/2016
(2)
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12/3/2025
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Common Stock
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4800
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$104.08
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D
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Employee Stock Option (Right to Buy)
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12/6/2017
(2)
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12/6/2026
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Common Stock
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3400
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$136.4
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D
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Common Stock Share Equivalents
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(4)
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(4)
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Common Stock
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124.2341
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$0
(3)
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I
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By nonqualified savings plan
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Explanation of Responses:
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(
1)
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Includes 790 shares held by the Company to implement restrictions on transfer unless and until certain conditions are met.
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(
2)
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The option vests in three substantially equal annual installments beginning on the date exercisable.
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(
3)
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Each unit is the economic equivalent of one share of Company common stock.
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(
4)
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The share equivalents are payable in cash upon retirement or after termination of employment.
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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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Fooks Elik I
1201 SOUTH SECOND STREET
MILWAUKEE, WI 53204
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Senior Vice President
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Signatures
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Karen A. Balistreri, Attorney-in-fact for Elik I. Fooks
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3/15/2017
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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 5(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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