Initial Statement of Beneficial Ownership (3)
30 Junho 2021 - 4:35PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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1. Name and Address of Reporting Person
*
Kenison Michael R. |
2. Date of Event Requiring Statement (MM/DD/YYYY)
6/28/2021
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3. Issuer Name and Ticker or Trading Symbol
Proto Labs Inc [PRLB]
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(Last)
(First)
(Middle)
5540 PIONEER CREEK DRIVE |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
VP and GM of the America's / |
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(Street)
MAPLE PLAIN, MN 55359
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Common Stock | 3338 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Employee Stock Option (right to buy) | (1) | 5/16/2028 | Common Stock | 465 | $117.5500 | D | |
| Employee Stock Option (right to buy) | (2) | 5/15/2029 | Common Stock | 1596 | $106.8500 | D | |
| Employee Stock Option (right to buy) | (3) | 5/19/2030 | Common Stock | 2081 | $117.0000 | D | |
| Explanation of Responses: |
| (1) | Stock option vests as follows: 232 shares vested on each May 20, 2019, May 20, 2020, and May 20, 2021 and 233 shares vest on May 20, 2022 |
| (2) | Stock option vests as follows: 531 shares vested on May 20, 2020; 532 shares vested on May 20, 2021; and 532 shares vest on each May 20, 2022 and May 20, 2023. |
| (3) | Stock option vests as follows: 520 shares vested on May 20, 2021; 520 shares vest on each May 20, 2022 and May 20, 2023; 521 shares vest on May 20, 2024. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Kenison Michael R.
5540 PIONEER CREEK DRIVE
MAPLE PLAIN, MN 55359 |
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| VP and GM of the America's |
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Signatures
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| /s/ W. Morgan Burns, Attorney-in-Fact | | 6/30/2021 |
| **Signature of Reporting Person | Date |
Proto Labs (NYSE:PRLB)
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