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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (right to buy) | $ 14.37 | 12/01/2009 | M(2) | 500 | 02/22/2005 | 01/22/2012 | Common Stock | 500 | $ 0 | 22,334 (1) | D | ||||
Stock Option (right to buy) | $ 14.37 | 12/02/2009 | M(2) | 10,000 | 02/22/2005 | 01/22/2005 | Common Stock | 10,000 | $ 0 | 12,334 (1) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Dubyak Michael E C/O WRIGHT EXPRESS CORPORATION 97 DARLING AVENUE SOUTH PORTLAND, ME 04016 |
X | Chairman, President & CEO |
/s/Hilary A. Rapkin, as attorney-in-fact for Michael E. Dubyak | 12/03/2009 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The option was granted to the reporting person and he is deemed to hold the option. However, a portion of the economic benefit of the option was transferred pursuant to a domestic relations order and he must exercise that portion of the option solely at the direction of his former spouse, who is entitled to the economic value upon exercise. The reporting person disclaims beneficial ownership of the option except to the extent of his pecuniary interest in that option. |
(2) | This option was exercised, and the shares of common stock received upon exercise were sold, at the direction of the reporting person's former spouse pursuant to interests granted to her under a domestic relations order. |
(3) | The price listed is a weighted average price for all shares sold. All shares were sold for between $30.02 and $30.12. Upon request, the reporting person will provide the Securities and Exchange Commission, Wright Express Corporation or any security holder of Wright Express Corporation with full information regarding the number of shares sold at each separate sale price. |