SEC Form 4
FORM 4 UNITED 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
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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*
Hagedorn Jason Dean

(Last) (First) (Middle)
600 EAST SECOND STREET

(Street)
MUSCATINE IA 52761

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
HNI CORP [ HNI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Allsteel Inc.
3. Date of Earliest Transaction (Month/Day/Year)
08/07/2021
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 08/07/2021 M(1) 2,322 A $38.61 16,630.925 D
Common Stock 08/07/2021 F(2) 705 D $38.61 15,925.925 D
Common Stock 583.49 I Profit-Sharing Retirement Plan
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 $0.0(3) 08/07/2021 M(1) 2,322 08/07/2021(4) (4) Common Stock 2,322 $0 0 D
Explanation of Responses:
1. Represents the conversion of Restricted Stock Units into Common Stock. On August 7, 2018, the reporting person was granted 4,645 Restricted Stock Units ("2018 Grant") to vest in two equal installments beginning on the second anniversary of the grant date. The first installment of 2,323 fully vested on August 7, 2020. The second installment of 2,322 fully vested on August 7, 2021.
2. The reporting person is reporting the withholding by the Issuer of an aggregate 705 shares of Common Stock that vested on August 7, 2021 pursuant to the 2018 Grant, but that were not issued in order to satisfy the reporting person's tax withholding obligations.
3. Each restricted stock unit represents a contingent right to receive one share of Issuer's Common Stock.
4. On August 7, 2018, the reporting person was granted 4,645 Restricted Stock Units, vesting in equal installments starting on the second anniversary of the grant date of the 2018 Grant. The first installment of Restricted Stock Units vested on August 7, 2020, and the remaining Restricted Stock Units vested on August 7, 2021 and is reported on Table I of this Form 4.
Remarks:
/s/ Steven M. Bradford, By Power of Attorney 08/10/2021
** 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).
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