SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Walker Ignacio J

(Last) (First) (Middle)
207 GOODE AVE

(Street)
GLENDALE CA 91203

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2020
3. Issuer Name and Ticker or Trading Symbol
Avery Dennison Corp [ AVY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP and Chief Legal Officer
5. 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
Table I - Non-Derivative Securities Beneficially Owned
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 2,373 D
Common Stock (Savings Plan) 536.0054 I Savings Plan
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: 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
2017 MSU Award 02/23/2018(1) 02/23/2021 Common Stock 476 0 D
2018 MSU Award 02/22/2019(1) 02/22/2022 Common Stock 761 0 D
2018 PU Award 02/22/2021(2) 02/22/2021 Common Stock 1,554 0 D
2019 MSU Award 02/28/2020(1) 02/28/2023 Common Stock 1,019 0 D
2019 PU Award 02/28/2022(3) 02/28/2022 Common Stock 1,653 0 D
2020 MSU Award 02/27/2021(1) 02/27/2024 Common Stock 1,547 0 D
2020 PU Award 02/27/2023(4) 02/27/2023 Common Stock 1,349 0 D
Explanation of Responses:
1. Market-leveraged stock units vest 25% over one-, two-, three- and four-year performance periods, with the number of shares paid on each vesting date based on the Company's absolute total stockholder return, plus dividend equivalents accrued during the vesting period. Each market-leveraged stock unit represents a contingent right to receive one share of Avery Dennison Corporation common stock, plus dividend equivalents.
2. Performance units vest, if at all, at the end of fiscal year 2020, provided certain performance objectives are met as determined by the Compensation Committee in February 2021. Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
3. Performance units vest, if at all, at the end of fiscal year 2021, provided certain performance objectives are met as determined by the Compensation Committee in February 2022. Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
4. Performance units vest, if at all, at the end of fiscal year 2022, provided certain performance objectives are met as determined by the Compensation Committee in February 2023. Each performance unit represents a contingent right to receive one share of Avery Dennison Corporation common stock.
/s/ Maribel Cabrera POA for Ignacio J Walker 09/03/2020
** 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 5 (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.
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