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*
STANDER DEON

(Last) (First) (Middle)
207 GOODE AVE.

(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)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP/General Manager, RBIS
3. Date of Earliest Transaction (Month/Day/Year)
02/27/2021
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 02/27/2021 M 1,266 A $177.45 27,006 D
Common Stock 02/27/2021 F 571 D $177.45 26,435 D
Common Stock 02/27/2021 M 1,447 A $177.45 27,882 D
Common Stock 02/27/2021 F 642 D $177.45 27,240 D
Common Stock 02/27/2021 M 1,827 A $177.45 29,067 D
Common Stock 02/27/2021 F 811 D $177.45 28,256 D
Common Stock 02/27/2021 M 1,242 A $177.45 29,498 D
Common Stock 02/27/2021 F 551 D $177.45 28,947 D
Common Stock 02/27/2021 M 4,809 A $177.45 33,756 D
Common Stock 02/27/2021 F 2,133 D $177.45 31,623 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
2017 MSU Award $0 02/27/2021 M 1,266(1) 02/23/2018 02/27/2021 Common Stock 1,266 $0 0 D
2018 MSU Award $0 02/27/2021 M 1,447(2) 02/22/2019 02/22/2022 Common Stock 1,447 $0 935 D
2019 MSU Award $0 02/27/2021 M 1,827(3) 02/28/2020 02/28/2023 Common Stock 1,827 $0 1,786 D
2020 MSU Award $0 02/27/2021 M 1,242(4) 02/27/2021 02/27/2024 Common Stock 1,242 $0 3,048 D
2018 PU Award $0 02/27/2021 M 4,809(5) 02/22/2021 02/27/2021 Common Stock 4,809 $0 0 D
2021 MSU Award $0 03/01/2021 A 2,312(6) 03/01/2022 03/01/2025 Common Stock 2,312 $0 2,312 D
2021 PU Award $0 03/01/2021 A 2,750(7) 03/01/2024 03/01/2024 Common Stock 2,750 $0 2,750 D
2021 Special PU Award $0 03/01/2021 A 2,547(8) 03/01/2024 03/01/2024 Common Stock 2,547 $0 2,547 D
Explanation of Responses:
1. Shares reflect the vesting of the fourth tranche of market-leveraged stock units granted in February 2017 at 200% of target based on our absolute total stockholder return in excess of 10% during the 2017-2020 performance period, plus dividend equivalents accrued during the period.
2. Shares reflect the vesting of the third tranche of market-leveraged stock units granted in February 2018 at 146% of target based on our absolute total stockholder return in excess of 10% during the 2018-2020 performance period, plus dividend equivalents accrued during the period.
3. Shares reflect the vesting of the second tranche of market-leveraged stock units granted in February 2019 at 197% of target based on our absolute total stockholder return in excess of 10% during the 2019-2020 performance period, plus dividend equivalents accrued during the period.
4. Shares reflect the vesting of the first tranche of market-leveraged stock units granted in February 2020 at 120% of target based on our absolute total stockholder return in excess of 10% during the 2020 performance period, plus dividend equivalents accrued during the period.
5. Shares reflect the vesting of performance units granted in February 2018 at 126% of target, 100% on RBIS's cumulative economic value added, as adjusted by the Compensation Committee in February 2021.
6. Market-leveraged stock units vest 25% over one-, two-, three- and four-year performance periods, with the number of shares paid on each vesting date based on our absolute total stockholder return, plus dividend equivalents accrued during the vesting period. Each market-leveraged stock unit represents a contingent right to receive one share of Avery Dennison Corporation common stock, plus dividend equivalents.
7. Performance units vest, if at all, at the end of fiscal year 2023, provided the designated performance objectives are met as determined by the Compensation Committee in February 2024. Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
8. Performance units vest, if at all, at the end of fiscal year 2023, provided the designated performance objectives are met as determined by the Compensation Committee in February 2024. Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
/s/ Vikas Arora POA for Deon Stander 03/02/2021
** Signature of Reporting Person Date
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