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*
Parks Douglas L

(Last) (First) (Middle)
300 RENAISSANCE CENTER
M/C: 482-C24-A68

(Street)
DETROIT MI 48265

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/01/2019
3. Issuer Name and Ticker or Trading Symbol
General Motors Co [ GM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Vice President
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 21,544 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
Employee Stock Option (Right to Buy)(1) (1) 07/28/2025 Common Stock 22,776 31.32 D
Employee Stock Option (Right to Buy)(2) (2) 06/07/2027 Common Stock 12,299 34.34 D
Restricted Stock Units(3) 10/02/2020 10/02/2020 Common Stock 17,794 (4) D
Employee Stock Option (Right to Buy)(5) (5) 02/11/2028 Common Stock 22,193 41.4 D
Employee Stock Option (Right to Buy)(6) (6) 02/13/2029 Common Stock 24,500 39 D
Explanation of Responses:
1. These Stock Options were granted on July 28, 2015, (the "Grant Date") under the Company's 2014 Long-Term Incentive Plan (the "DSV Options") and will vest on February 15, 2020, provided that the Company meets or exceeds the median total shareholder return of the 14 original equipment manufacturers (other than GM) on the Dow Jones Automobiles and Parts Titans 30 Index on the Grant Date for the performance period from July 28, 2015, through December 31, 2019.
2. These Stock Options were granted on June 7, 2017, under the Company's 2017 Long-Term Incentive Plan (the "2017 LTIP") and will vest on February 14, 2020.
3. These Restricted Stock Units ("RSUs") were awarded on October 2, 2017, under the 2017 LTIP. The RSUs will vest and settle, contingent upon the officer's continued employment with the Company, in shares of common stock on a one-for-one basis on October 2, 2020.
4. The RSUs do not have a conversion or exercise price.
5. These Stock Options were granted on February 13, 2018, under the 2017 LTIP. One-third of the 22,193 Stock Options granted have vested; one-third will vest on February 13, 2020; and one-third will vest on February 13, 2021.
6. These Stock Options were granted on February 13, 2019, under the 2017 LTIP. One-third of the 24,500 Stock Options granted will vest on February 13, 2020; one-third will vest on February 13, 2021; and one-third will vest on February 13, 2022.
Remarks:
/s/ Tia Y. Turk, Attorney-in-Fact for Mr. Parks 11/08/2019
** 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.
poaparksdouglasl11042019