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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 | ||||||||
Stock Option (right to buy) | $ 24.55 | 12/01/2010 | M | 7,500 | (4) | 07/20/2011 | Common Stock | 7,500 | $ 0 | 0 | D | ||||
Stock Appreciation Right | $ 25.81 | 12/01/2010 | M | 113,190 | (5) | 11/17/2015 | Common Stock | 113,190 | $ 0 | 56,595 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
JACKSON DARREN R ADVANCE AUTO PARTS, INC. 5008 AIRPORT RD ROANOKE, VA 24012 |
X | CEO |
/s/ Rachel E. Geiersbach, as Attorney-in-Fact for Darren R. Jackson | 12/02/2010 | |
**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) | Represents shares withheld to satisfy a tax withholding obligation upon the vesting of restricted stock. |
(2) | The reported transaction reflects the exercise of stock options scheduled to expire in 2011 and the sale of the resulting shares and was completed in accordance with the reporting person's personal tax planning strategies. Following this transaction, Mr. Jackson retains a substantial ownership position in both beneficially owned stock and vested SARs, and his ownership currently fulfills and continues to exceed the Company's stock ownership guidelines for the CEO. |
(3) | The reported transaction reflects the exercise of SARs and satisfaction of the reporting person's tax withholding obligations in the form of shares resulting from the exercise. |
(4) | These shares became exercisable in three equal annual installments beginning on July 20, 2005. |
(5) | These shares became exercisable in three equal annual installments beginning on November 17, 2009. |