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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 | ||||||||
Variable Prepaid Forward Contract | (1) (2) | 11/07/2012 | J(1)(2) | 1,000,000 | 11/07/2012 | 11/07/2012 | Common Stock | 1,000,000 | $ 0 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 20.11 | 03/14/2013 | 03/14/2018 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $ 18.36 | 03/06/2011 | 03/06/2019 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $ 42.6 | 03/12/2012 | 03/12/2020 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $ 51.6 | 03/11/2013 | 03/11/2021 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $ 76.86 | 03/09/2014 | 03/09/2022 | Common Stock | 15,000 | 15,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 26.905 | 03/09/2012 | 03/09/2017 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 7.4063 | 06/28/2003 | 06/28/2020 | Common Stock | 288,000 | 288,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 5.6475 | 06/12/2006 | 06/12/2013 | Common Stock | 48,000 | 48,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 9.02 | 09/04/2008 | 09/04/2013 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 10.495 | 06/03/2009 | 06/03/2014 | Common Stock | 40,000 | 40,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 15.7025 | 06/03/2010 | 06/03/2015 | Common Stock | 20,000 | 20,000 | D | ||||||||
Non-Quallified Stock Option (right to buy) | $ 21.755 | 03/09/2011 | 03/09/2016 | Common Stock | 20,000 | 20,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ILLIG CLIFFORD W 2800 ROCKCREEK PARKWAY NORTH KANSAS CITY, MO 64117 |
X | Vice Chairman |
/s/Amy Abrams, by Power of Attorney | 11/08/2012 | |
**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) | On November 7, 2012, the reporting person settled a variable prepaid forward contract ("VPFC") that had been entered into pursuant to a letter agreement dated November 9, 2009, as amended, with an unaffiliated third party. Under the terms of the VPFC, at maturity the reporting person was obligated to deliver to the third party up to 1,000,000 shares of Cerner Corporation common stock, the precise amount being dependent on the market price at maturity. Information regarding the terms of the VPFC were disclosed as part of the reporting person's Form 4 filing on November 9, 2009. |
(2) | Because of the closing of the U.S. stock markets caused by Hurricane Sandy, the maturity date was extended to November 7, 2012. On November 7, 2012, the final valuation (which is calculated as the volume weighted average price per share on each of the 6 scheduled trading days starting on October 30, 2012) was $78.24 and, accordingly, the reporting person delivered 803,443 shares of Cerner Corporation common stock to the third party. |