SEC Form 5
FORM 5 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol LIBBEY INC [ LBY ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 12/31/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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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 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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Phantom Stock Units | (1) | 12/15/2009 | A | 154.03 | 08/08/1998(2) | (2) | Common Stock | 154.103 | $7.1 | 154.103 | D | |||
Phantom Stock Units | (1) | 12/31/2009 | A | 143.024 | 08/08/1998(2) | (2) | Common Stock | 143.024 | $7.65 | 297.127 | D | |||
Phantom Stock Units | (1) | 12/15/2010 | A | 120.097 | 08/08/1998(2) | (2) | Common Stock | 120.097 | $14.35 | 417.224 | D | |||
Phantom Stock Units | (1) | 12/31/2010 | A | 111.402 | 08/08/1998(2) | (2) | Common Stock | 111.402 | $15.47 | 528.626 | D | |||
Phantom Stock Units | (1) | 12/15/2011 | A | 190.105 | 08/08/1998(2) | (2) | Common Stock | 190.105 | $12.42 | 718.731 | D | |||
Phantom Stock Units | (1) | 12/30/2011 | A | 185.329 | 08/08/1998(2) | (2) | Common Stock | 185.329 | $12.74 | 904.06 | D | |||
Phantom Stock Units | (1) | 12/14/2012 | A | 86.833 | 08/08/1998(2) | (2) | Common Stock | 86.833 | $19.32 | 990.893 | D | |||
Phantom Stock Units | (1) | 12/31/2012 | A | 96.332 | 08/08/1998(2) | (2) | Common Stock | 96.332 | $19.35 | 1,193.172(3) | D |
Explanation of Responses: |
1. The phantom stock units convert to common stock on a 1-for-1 basis. |
2. Phantom stock units acquired upon deferral of cash compensation under the Libbey executive deferred compensation plan (the "Plan"), a 16b-3 plan. Each phantom stock unit is the economic equivalent of one share of Libbey Inc. common stock. The number of phantom stock units acquired is equivalent to the dollar value of the cash compensation earned based on the market value of Libbey Inc. shares at the time the compensation was earned. The market value of Libbey Inc. shares is the closing price of the Libbey Inc. shares on the New York Stock Exchange on the day the compensation is earned. The units earned are settled in cash at such time as prescribed by the Plan. |
3. Total includes 105.947 phantom stock units acquired during the years 2015 through 2017 under the Plan's dividend-equivalent reinvestment feature. |
Remarks: |
Debbie Hyndman, Attorney-in-Fact for Susan A. Kovach | 02/14/2018 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |