Initial Statement of Beneficial Ownership (3)
May 26 2016 - 4:19PM
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
*
Klimek Amy M.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
5/16/2016
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3. Issuer Name
and
Ticker or Trading Symbol
WOLVERINE WORLD WIDE INC /DE/ [WWW]
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(Last)
(First)
(Middle)
C/O 9341 COURTLAND DRIVE NE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Sr. VP of Human Resources /
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(Street)
ROCKFORD, MI 49351
(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)
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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
(1)
(2)
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17441
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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. 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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Stock Option (Right to Buy)
(1)
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10/9/2015
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10/8/2023
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Common Stock
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518
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$28.99
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D
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Stock Option (Right to Buy)
(1)
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10/9/2016
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10/8/2023
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Common Stock
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518
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$28.99
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D
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Stock Option (Right to Buy)
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2/11/2016
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2/10/2024
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Common Stock
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1348
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$27.13
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D
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Stock Option (Right to Buy)
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2/11/2017
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2/10/2024
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Common Stock
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1349
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$27.13
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D
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Stock Option (Right to Buy)
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4/22/2015
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4/21/2024
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Common Stock
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355
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$27.21
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D
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Stock Option (Right to Buy)
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4/22/2016
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4/21/2024
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Common Stock
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354
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$27.21
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D
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Stock Option (Right to Buy)
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4/22/2017
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4/21/2024
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Common Stock
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355
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$27.21
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D
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Stock Option (Right to Buy)
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2/11/2016
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2/10/2025
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Common Stock
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1771
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$28.00
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D
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Stock Option (Right to Buy)
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2/11/2017
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2/10/2025
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Common Stock
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1770
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$28.00
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D
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Stock Option (Right to Buy)
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2/11/2018
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2/10/2025
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Common Stock
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1770
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$28.00
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D
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Stock Option (Right to Buy)
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2/10/2017
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2/9/2026
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Common Stock
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3405
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$16.51
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D
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Stock Option (Right to Buy)
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2/10/2018
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2/9/2026
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Common Stock
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3404
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$16.51
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D
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Stock Option (Right to Buy)
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2/10/2019
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2/9/2026
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Common Stock
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3405
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$16.51
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D
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Explanation of Responses:
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(
1)
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The number of shares and exercise price have been adjusted to reflect the Company's November 1, 2013 two-for-one stock split.
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(
2)
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The number of shares reported includes 9,913 time-vested restricted shares of common stock granted to the reporting person on various dates from October 2013 to February 2016, under the Company's Stock Incentive Plan of 2013.
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Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
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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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Klimek Amy M.
C/O 9341 COURTLAND DRIVE NE
ROCKFORD, MI 49351
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Sr. VP of Human Resources
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Signatures
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/s/ Timothy E. Foley, by Power of Attorney
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5/26/2016
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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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