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Potter Beth – ‘4’ for 2/21/20 re: NCR Corp.

On:  Tuesday, 2/25/20, at 9:44pm ET   ·   For:  2/21/20   ·   Accession #:  1209191-20-12838   ·   File #:  1-00395

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  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 2/25/20  Potter Beth                       4                      1:12K  NCR Corp.                         DONNELLEY FIN… File16/FA

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Form 4 Submission -- doc4.xml/3.6                   HTML      3K 




        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
SEC Info rendering:  Form 4 Submission
 
FORM 4UNITED 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*
Potter Beth

(Last)(First)(Middle)
864 SPRING STREET NW

(Street)
ATLANTAGA30308

(City)(State)(Zip)
2. Issuer Name and Ticker or Trading Symbol
NCR CORP [ NCR ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
XOfficer (give title below) Other (specify below)
CAO
3. Date of Earliest Transaction (Month/Day/Year)
2/21/20
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
XForm 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)
CodeVAmount(A) or (D)Price
Common Stock 2/23/20M 347 (1)A$12.8122,275D
Common Stock 2/23/20F 61 (2)D$31.2822,214D
Common Stock 2/23/20F 205 (3)D$31.2822,009D
Common Stock 2/24/20M 6,698 (4)A$29.6428,707D
Common Stock 2/24/20F 2,017D$29.6426,690D
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)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Restricted Stock Units$12.81 2/23/20M 347 (5) 2/23/11 2/23/20Common Stock347$0.000D
Restricted Stock Units$0.00 (4) 2/24/20M 6,698 (4) (4) (4)Common Stock6,698$0.006,698D
Explanation of Responses:
(1)  The exercise and sale reported in this Form 4 occurred pursuant to the automatic option exercise of a stock option per Company policy on the option expiration date.
(2)  These shares were withheld to cover tax withholdings obligations upon the exercise or the option reported in this Form 4. These shares were rounded to 61 for disclosure in this table.
(3)  These shares were withheld to cover tax withholding obligations when 678 previously reported restricted stock units vested on February 23, 2020.
(4)  Represents the conversion of restricted stock units that vested on February 24, 2020. The performance related conditions of these restricted stock units were satisfied on December 9, 2016.
(5)  The exercise and sale reported in this Form 4 occurred pursuant to the automatic exercise of a stock option per Company policy on the option expiration date.
Remarks:
Laura J. Foltz, Attorney-in-Fact for Beth Potter 2/25/20
** Signature of Reporting PersonDate
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.
____________
Transaction Codes:
    F    Payment of exercise price or tax liability by delivering or withholding securities incident to the receipt, exercise or vesting of a security issued in accordance with Rule 16b-3.
    M    Exercise or conversion of derivative security exempted pursuant to Rule 16b-3.

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