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) 05/11/2017 | 3. Issuer Name and Ticker or Trading Symbol GARDNER DENVER HOLDINGS, INC. [ GDI ] | |||||||||||||
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 | 132,026 | D | |
Common Stock | 75,000 | I | See footnote(1) |
Common Stock | 25,000 | I | See footnote(2) |
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 | ||||
Stock Options (Right to Buy) | (3) | 05/24/2025 | Common Stock | 657,731 | 10.61 | D | |
Stock Options (Right to Buy) | (4) | 05/10/2026 | Common Stock | 390,269 | 10.61 | D |
Explanation of Responses: |
1. Held in a trust for the benefit of the Reporting Person's descendants. |
2. Held in a trust for the benefit of the Reporting Person's spouse and descendants. |
3. Of this stock option award, 438,487 stock options are currently vested, with an additional 438,487 stock options eligible to vest in equal installments on each of December 31, 2017 and December 31, 2018, where 50% of such unvested options are eligible to vest on such dates, or later dates, subject to the satisfaction of future performance-based vesting conditions and are not included in the table above. |
4. Of this stock option award, 195,134 stock options are currently vested, with an additional 390,269 stock options eligible to vest in equal installments on each of December 31, 2017 and December 31, 2018, where 50% of such unvested options are eligible to vest on such dates, or later dates, subject to the satisfaction of future performance-based vesting conditions and are not included in the table above. |
Remarks: |
The Reporting Person states that this filing shall not be an admission that the Reporting Person is the beneficial owner of any of the securities reported herein as indirectly beneficially owned, and the Reporting Person disclaims beneficial ownership of such securities except to the extent of the Reporting Person's pecuniary interest therein. Exhibit List: Exhibit 24 - Power of Attorney |
/s/ Andrew Schiesl, as Attorney-in-Fact | 05/11/2017 | |
** 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. |