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
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
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*
Butier Mitchell R

(Last) (First) (Middle)
8080 NORTON PARKWAY

(Street)
MENTOR OH 44060

(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
X Officer (give title below) Other (specify below)
Executive Chairman
3. Date of Earliest Transaction (Month/Day/Year)
03/01/2024
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
Rule 10b5-1(c) Transaction Indication

  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
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 (Savings Plan) 4,148.301 I Savings Plan
Common Stock 03/01/2024 M 10,482 A $216.45 314,596 D
Common Stock 03/01/2024 F 6,011 D $216.45 308,585 D
Common Stock 03/01/2024 M 5,702 A $216.45 314,287 D
Common Stock 03/01/2024 F 3,271 D $216.45 311,016 D
Common Stock 03/01/2024 M 6,022 A $216.45 317,038 D
Common Stock 03/01/2024 F 3,454 D $216.45 313,584 D
Common Stock 03/01/2024 M 5,440 A $216.45 319,024 D
Common Stock 03/01/2024 F 3,120 D $216.45 315,904 D
Common Stock 03/01/2024 M 32,243 A $216.45 348,147 D
Common Stock 03/01/2024 F 18,492 D $216.45 329,655 D
Common Stock 03/04/2024 S 547 D $218.7219(1) 329,108 D
Common Stock 03/04/2024 S 7,621 D $217.259(2) 321,487 D
Common Stock 03/05/2024 S 7,333 D $215.6874(3) 314,154 D
Common Stock 03/05/2024 S 9,240 D $217.1294(4) 304,914 D
Common Stock 03/05/2024 S 800 D $217.6319(5) 304,114 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
2020 MSU Award $0 03/01/2024 M 10,482 02/27/2021(6) 03/01/2024 Common Stock 10,482 $0 0 D
2021 MSU Award $0 03/01/2024 M 5,702 03/01/2022(7) 03/01/2025 Common Stock 5,702 $0 4,061 D
2022 MSU Award $0 03/01/2024 M 6,022 03/01/2023(8) 03/01/2026 Common Stock 6,022 $0 12,377 D
2023 MSU Award $0 03/01/2024 M 5,440 03/01/2024(9) 03/01/2027 Common Stock 5,440 $0 16,362 D
2021 PU Award $0 03/01/2024 M 32,243 03/01/2024(10) 03/01/2024 Common Stock 32,243 $0 0 D
2024 RSU Award $0 03/01/2024 A 23,101 03/01/2025(11) 03/01/2025 Common Stock 23,101 $0 23,101 D
Explanation of Responses:
1. Transaction executed in multiple trades at prices ranging from $218.500 - 219.040. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer, or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
2. Transaction executed in multiple trades at prices ranging from $217.000 - 217.860. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer, or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
3. Transaction executed in multiple trades at prices ranging from $215.500 - 216.445. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer, or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
4. Transaction executed in multiple trades at prices ranging from $216.530 - 217.500. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer, or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
5. Transaction executed in multiple trades at prices ranging from $217.555 - 217.670. The price reported reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer, or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected.
6. Shares reflect the vesting of the fourth tranche of MSUs granted in February 2020 at 180% of target based on our absolute total stockholder return in excess of 10% during the 2020-2023 performance period, plus dividend equivalents accrued during the period.
7. Shares reflect the vesting of the third tranche of MSUs granted in March 2021 at 134% of target based on our absolute total stockholder return in excess of 10% during the 2021-2023 performance period, plus dividend equivalents accrued during the period.
8. Shares reflect the vesting of the second tranche of MSUs granted in March 2022 at 94% of target based on our absolute total stockholder return during the 2022-2023 performance period, plus dividend equivalents accrued during the period.
9. Shares reflect the vesting of the first tranche of MSUs granted in March 2023 at 98% of target based on our absolute total stockholder return during the 2023 performance period, plus dividend equivalents accrued during the period.
10. Shares reflect the vesting of PUs granted in March 2021 at 183% of target, based 50% on our cumulative economic value added and 50% on our relative total stockholder return.
11. Restricted stock units (RSUs) cliff vest on the first anniversary of the grant date. Each RSU represents a contingent right to receive one share of common stock.
/s/ Vikas Arora attorney-in-fact for Mitchell R Butier 03/05/2024
** 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).
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.