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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
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 Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Performance Shares | $ 0 (1) | 08/02/2012 | A | 447,155 (1) | 08/02/2014(1) | 08/02/2014(1) | Common Stock | 447,155 (1) | $ 0 | 447,155 (1) | D | ||||
Restricted Stock Units | $ 0 (2) | 08/02/2012 | A | 447,155 | 08/02/2014(3) | (3) | Common Stock | 447,155 | $ 0 | 447,155 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SALES WAYNE C 11840 VALLEY VIEW ROAD EDEN PRAIRIE, MN 55344 |
X | President, CEO & Chairman |
By: Todd N. Sheldon, Attorney in Fact For: Wayne C. Sales | 08/03/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The performance stock units represent a contingent right to receive shares of SUPERVALU common stock on the second anniversary of the grant date based on achievement of the performance criteria set forth in the award agreement. The number of performance stock units set forth above reflects the target number of shares of common stock subject to the award. The actual number of shares of common stock to be issued to the holder upon vesting of the performance stock units will be determined one year from the date of grant and can range from 0% to 300% of the target number of shares listed above. |
(2) | Each restricted stock unit represents a contingent right to receive one share of SUPERVALU common stock. |
(3) | The restricted stock units will be converted into shares of SUPERVALU common stock on the second anniversary of the grant date, unless such units were vested and converted earlier upon a change of control of the company or upon the holder's separation from service, death or disability. |