SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 09/28/2015 | 3. Issuer Name and Ticker or Trading Symbol JACK IN THE BOX INC /NEW/ [ JACK ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
COMMON STOCK | 1,356(1) | D | |
COMMON STOCK | 1,000(2) | D | |
COMMON STOCK | 870 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
NON-QUALIFIED STOCK OPTION(3) | 11/26/2013 | 11/26/2019 | COMMON STOCK | 1,569 | 27.49 | D | |
NON-QUALIFIED STOCK OPTION(4) | 11/26/2014 | 11/26/2020 | COMMON STOCK | 2,887 | 47.29 | D | |
NON-QUALIFIED STOCK OPTION(4) | 11/25/2015 | 11/25/2021 | COMMON STOCK | 1,556 | 73.53 | D |
Explanation of Responses: |
1. These securites represent the unvested portion of restricted stock unit grants made on 11/26/2012, 11/26/2013, and 11/25/2014. The grants of restricted stock units vest in five equal installments commencing one year after the date of grant, with after-tax net shares subject to a minimum 50% holding requirement until separation of service with the Company. |
2. These securities represent unvested restricted stock units granted on 9/27/2012. This grant vests upon the opening of the Company's trading window following the third anniversary of the grant date. |
3. The option became exercisable in three equal installments commencing one year after the date of grant, and becomes exercisable as to the remaining 1,569 shares on November 26, 2015. |
4. These options become exercisable in three equal installments commencing one year after the date of grant. |
Remarks: |
DEAN C GORDON | 09/28/2015 | |
** 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 5 (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. |