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*
Melo Francisco

(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)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Solutions Group
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 03/01/2024 M 600 A $216.45 17,505 D
Common Stock 03/01/2024 F 22 D $216.45 17,483 D
Common Stock 03/01/2024 M 372 A $216.45 17,855 D
Common Stock 03/01/2024 F 175 D $216.45 17,680 D
Common Stock 03/01/2024 M 405 A $216.45 18,085 D
Common Stock 03/01/2024 F 191 D $216.45 17,894 D
Common Stock 03/01/2024 M 575 A $216.45 18,469 D
Common Stock 03/01/2024 F 271 D $216.45 18,198 D
Common Stock 03/01/2024 M 1,477 A $216.45 19,675 D
Common Stock 03/01/2024 F 695 D $216.45 18,980 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
2024 MSU Award $0 03/01/2024 A 1,796 03/01/2025(1) 03/01/2028 Common Stock 1,796 $0 1,796 D
2024 PU Award $0 03/01/2024 A 2,178 03/01/2027(2) 03/01/2027 Common Stock 2,178 $0 2,178 D
2020 MSU Award $0 03/01/2024 M 600 02/27/2021(3) 03/01/2024 Common Stock 600 $0 0 D
2021 MSU Award $0 03/01/2024 M 372 03/01/2022(4) 03/01/2025 Common Stock 372 $0 266 D
2022 MSU Award $0 03/01/2024 M 405 03/01/2023(5) 03/01/2026 Common Stock 405 $0 832 D
2023 MSU Award $0 03/01/2024 M 575 03/01/2024(6) 03/01/2027 Common Stock 575 $0 1,733 D
2021 PU Award $0 03/01/2024 M 1,477 03/01/2024(7) 03/01/2024 Common Stock 1,477 $0 0 D
Explanation of Responses:
1. Market-leveraged stock units (MSUs) 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. Each MSU represents a contingent right to receive one share of common stock, plus dividend equivalents accrued during the vesting period.
2. Performance units (PUs) vest, at the end of fiscal year 2026, provided certain performance objectives are met as determined by the Compensation Committee in February 2027. Each PU represents a contingent right to receive one share of common stock.
3. 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.
4. 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.
5. 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.
6. 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.
7. Shares reflect the vesting of PUs granted in March 2021 at 123% of target, based 75% on the cumulative economic value added of RBIS (now Solutions Group) and 25% on our relative total stockholder return.
/s/ Vikas Arora, attorney-in-fact for Francisco Melo 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).
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