SEC Form 4
Washington, D.C. 20549


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 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*
Dalton Travis

(Last) (First) (Middle)


(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & Chief Client & Serv. Off
3. Date of Earliest Transaction (Month/Day/Year)
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
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 403 I by 401(k) Plan
Common Stock 432 I by ASPP account
Common Stock 4,000(1) 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
Restricted Stock Units $0.00 03/26/2021 A 7,255(2) 04/28/2023 04/28/2023 Common Stock 7,255 $0.00(3) 7,255 D
Non-Qualified Stock Option (right to buy) $55.24 05/10/2018 05/10/2026 Common Stock 4,000 4,000 D
Non-Qualified Stock Option (right to buy) $65.27 05/01/2019 05/01/2027 Common Stock 10,000 10,000 D
Non-Qualified Stock Option (right to buy) $57.24 05/04/2020 05/04/2028 Common Stock 14,547 14,547 D
Non-Qualified Stock Option (right to buy) $65.88 04/29/2020 04/29/2029 Common Stock 9,662 9,662 D
Restricted Stock Units $0.00 04/30/2021 04/28/2023 Common Stock 14,412 14,412 D
Restricted Stock Units $0.00 04/29/2020 04/29/2022 Common Stock 9,018 9,018 D
Restricted Stock Units $0.00 02/12/2022 02/12/2023 Common Stock 6,672 6,672 D
Explanation of Responses:
1. Includes 4,000 shares of restricted common stock.
2. Reporting person was granted performance-based restricted stock units on April 30, 2020, which are earned based on the attainment of established performance criteria unrelated to the Company's stock price. As a result of our Q4 2020 performance relative to the attainment of the established Adjusted Operating Margin performance targets, the number of shares listed in this Table II were banked upon Compensation Committee approval, and will be banked until April 28, 2023, the vest date, subject to continued employment through such date. Each restricted stock unit represents a contingent right to receive one share of Cerner Corporation common stock.
3. This transaction represents a grant of restricted stock units to the reporting person by the issuer. Therefore, no consideration other than the value of services rendered was paid for the security.
/s/ Shane M. Dawson, by Power of Attorney 03/29/2021
** 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).
** 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.