SEC FORM 3 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*
Courtney Thomas J Jr.

(Last) (First) (Middle)
C/O HASBRO, INC.
1011 NEWPORT AVENUE

(Street)
PAWTUCKET RI 02861

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/02/2017
3. Issuer Name and Ticker or Trading Symbol
HASBRO INC [ HAS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, Global Operations
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 (Par Value $.50 per share) 29,417.87(1) D
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
Stock Option (Right to Buy)(2) (3) 02/12/2021 Common Stock 12,225 52.11 D
Stock Option (Right to Buy)(2) (4) 02/11/2022 Common Stock 12,189 61.77 D
Stock Option (Right to Buy)(2) (5) 02/11/2023 Common Stock 9,186 74.42 D
Explanation of Responses:
1. The Amount of Securities Benefically Owned include 4,056 shares of unvested restricted stock units.
2. These options were granted pursuant to an employee stock option plan in accordance with Rule 16b-3 and have tandem tax withholding rights.
3. 4,075 of the options became exercisable each on February 12, 2015, February 12, 2016 and February 12, 2017.
4. 4,063 of the options became exercisable each on February 11, 2016 and February 11, 2017. 4,063 of the options will become exercisable on February 11, 2018.
5. 3,062 of the options became exercisable on February 23, 2017 and 3,062 of the options will become exercisable on each February 23, 2018 and February 23, 2019 subject to the optionee's continued employment through those dates.
Tarrant Sibley, P/O/A for Thomas J. Courtney, Jr. 03/13/2017
** 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).
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