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*
Ford III Henry

(Last) (First) (Middle)
ONE AMERICAN ROAD

(Street)
DEARBORN MI 48126

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/13/2021
3. Issuer Name and Ticker or Trading Symbol
FORD MOTOR CO [ F ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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, $0.01 par value 1,464 D
Common Stock, $0.01 par value 1,506 I By Company Plan
Common Stock, $0.01 par value 422,730 I By Self as Trustee(1)
Common Stock, $0.01 par value 7,100 I By Spouse as Trustee(2)
Class B Stock, $0.01 par value 4,252 I By Voting Trust - Individually(3)
Class B Stock, $0.01 par value 15,824 I By Voting Trust - By Trust(4)
Class B Stock, $0.01 par value 1,163,601 I By Voting Trust - By Self as Trustee(5)
Class B Stock, $0.01 par value 51,692 I By Voting Trust - Spouse as Trustee(6)
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
Ford Stock Units (7) (7) Common Stock, $0.01 par value 4,189 (7) D
Ford Stock Units (8) (8) Common Stock, $0.01 par value 1,570 (8) D
Ford Stock Units (9) (9) Common Stock, $0.01 par value 771 (9) D
Explanation of Responses:
1. These shares are held in a trust of which I am the trustee.
2. My spouse is trustee of these trusts that benefit my family.
3. The voting trust holds 4,252 shares of Class B stock for my benefit.
4. The voting trust holds 15,824 shares of Class B stock for the benefit of a trust of which I am a beneficiary.
5. The voting trust holds 1,163,601 shares of Class B stock for the benefit of a trust of which I am the trustee.
6. The voting trust holds 51,692 shares of Class B stock for the benefit of trusts, of which my spouse is trustee, that benefit my family.
7. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 1,382 on March 4, 2022, 1,382 on March 4, 2023, and 1,425 on March 4, 2024.
8. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 773 on March 4, 2022 and 797 on March 4, 2023.
9. These Ford Restricted Stock Units were acquired under the Company's Long-Term Incentive Plan without payment by me. These Ford Restricted Stock Units will be converted and distributed to me, without payment, to the extent of 771 on March 4, 2022.
Remarks:
Victoria Pool, Attorney-in-Fact 05/24/2021
** 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 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.
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.