Statement of Changes in Beneficial Ownership (4)
February 25 2021 - 5:14PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
*
Campbell Daniel William |
2. Issuer Name and Ticker or Trading Symbol
NCR CORP
[
NCR
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) Executive VP, Global Sales |
(Last)
(First)
(Middle)
864 SPRING STREET NW |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/23/2021 |
(Street)
ATLANTA, GA 30308
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock | 2/23/2021 | | M | | 5117 (1) | A | $0.00 | 49061 | D | |
Common Stock | 2/23/2021 | | F | | 2251 (2) | D | $35.41 | 46810 | D | |
Common Stock | 2/23/2021 | | A | | 31771 (3) | A | $35.41 | 78581 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units | $0.00 (1) | 2/23/2021 | | M | | 5117 (1) | | (1) | (1) | Common Stock | 5117 | $0.00 | 0 | D | |
Explanation of Responses: |
(1) | Represents the conversion of restricted stock units that vested on February 23, 2021. The performance related conditions of these restricted stock units were satisfied on February 7, 2019. |
(2) | These shares were withheld to cover tax withholding obligations when 5,117 previously reported restricted stock units vested on February 23, 2021. |
(3) | Full settlement of an award under the long-term NCR Strategic Transformation Fitness Plan pursuant to the Second Amended and Restated NCR Management Incentive Plan in the form of Restricted Stock Units (RSUs) granted on February 23, 2021 that will vest in full on December 31, 2021, generally subject to the reporting person's continued employment with the issuer through the vesting date in accordance with the RSU award agreement. Net shares issued on settlement of these RSUs will be subject to an additional 1-year holding period. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Campbell Daniel William 864 SPRING STREET NW ATLANTA, GA 30308 |
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| Executive VP, Global Sales |
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Signatures
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Laura J. Foltz, Attorney-in-Fact for Daniel William Campbell | | 2/25/2021 |
**Signature of Reporting Person | Date |
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