SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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).
1. Name and Address of Reporting Person*
Alford Bradley A

(Last) (First) (Middle)
207 GOODE AVENUE

(Street)
GLENDALE CA 91203

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Avery Dennison Corp [ AVY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
04/29/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/29/2016 M 1,015 A $72.82 8,079 D
Common Stock 04/29/2016 M 859 A $72.82 8,938 D
Common Stock 04/29/2016 M 746 A $72.82 9,684 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
2013 Director RSU Award $0 04/29/2016(1) M 1,015(2) 05/01/2014 05/01/2016 Common Stock 1,015 $0 0 D
2014 Director RSU Award $0 04/29/2016(1) M 859(3) 05/01/2015 05/01/2017 Common Stock 859 $0 859 D
2015 Director RSU Award $0 04/29/2016(1) M 746(4) 05/01/2016 05/01/2018 Common Stock 746 $0 1,493 D
2016 Director RSU Award $0 05/01/2016(5) A 1,922(6) 05/01/2017 05/01/2019 Common Stock 1,922 $0 1,922 D
Common Stock Units - DDECP $0 08/08/1988 08/08/1988 Common Stock 13,889.5168 13,889.5168 I DDECP
Explanation of Responses:
1. Because the vesting date of the restricted stock units fell on a weekend, they vested on April 29, 2016, the last trading day prior to the vesting date.
2. Shares reflect the vesting of the third tranche of restricted stock units granted on May 1, 2013.
3. Shares reflect the vesting of the second tranche of restricted stock units granted on May 1, 2014.
4. Shares reflect the vesting of the first tranche of restricted stock units granted on May 1, 2015.
5. Because the grant date of the restricted stock units fell on a weekend, the grant date fair market value was based on April 29, 2016, the last trading day prior to the grant date.
6. The restricted stock units vest in three cumulative installments on the first, second and third anniversaries of the date of grant. Each restricted stock unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
/s/ Erica Perry POA for Bradley A Alford 05/02/2016
** 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).
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