10-12B: Initial general form for registration of a class of securities pursuant to Section 12(b)
Published on December 3, 2015
As filed with the Securities and Exchange Commission on December 3, 2015
File No.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form 10
GENERAL FORM FOR REGISTRATION OF SECURITIES
Pursuant to Section 12(b) or (g) of the Securities Exchange Act of 1934
Fortive Corporation
(Exact name of registrant as specified in its charter)
Delaware | 47-5654583 | |
(State or other jurisdiction of incorporation or organization) |
(I.R.S. employer identification number) |
|
6920 Seaway Blvd Everett, WA |
98203 | |
(Address of principal executive offices) |
(Zip code) |
Registrants telephone number, including area code (202) 828 - 0850
Securities to be registered pursuant to Section 12(b) of the Act:
Title of each class to be so registered |
Name of each exchange on which each class is to be registered |
|
Common stock, par value $0.01 per share |
New York Stock Exchange |
Securities to be registered pursuant to Section 12(g) of the Act: None
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of large accelerated filer, accelerated filer and smaller reporting company in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filer ¨ |
Accelerated filer ¨ | Non-accelerated filer x (Do not check if a smaller reporting company) |
Smaller reporting company ¨ |
FORTIVE CORPORATION
INFORMATION REQUIRED IN REGISTRATION STATEMENT
CROSS-REFERENCE SHEET BETWEEN INFORMATION STATEMENT
AND ITEMS OF FORM 10
Certain information required to be included herein is incorporated by reference to specifically identified portions of the body of the information statement of Fortive Corporation (Fortive) filed herewith as Exhibit 99.1. None of the information contained in the information statement shall be incorporated by reference herein or deemed to be a part hereof, unless such information is specifically incorporated by reference.
Item 1. Business.
The information required by this item is contained under the sections of the information statement entitled Information Statement Summary, Cautionary Statement Concerning Forward-Looking Statements, Risk Factors, Managements Discussion and Analysis of Financial Condition and Results of Operations, Business, Certain Relationships and Related Person Transactions and Where You Can Find More Information. Those sections are incorporated herein by reference.
Item 1A. Risk Factors.
The information required by this item is contained under the sections of the information statement entitled Risk Factors and Cautionary Statement Concerning Forward-Looking Statements. Those sections are incorporated herein by reference.
Item 2. Financial Information.
The information required by this item is contained under the sections of the information statement entitled Selected Historical Combined Financial Data, Capitalization, Unaudited Pro Forma Combined Financial Statements and Managements Discussion and Analysis of Financial Condition and Results of Operations. Those sections are incorporated herein by reference.
Item 3. Properties.
The information required by this item is contained under the section of the information statement entitled BusinessProperties. That section is incorporated herein by reference.
Item 4. Security Ownership of Certain Beneficial Owners and Management.
The information required by this item is contained under the section of the information statement entitled Security Ownership of Certain Beneficial Owners and Management. That section is incorporated herein by reference.
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Item 5. Directors and Executive Officers.
The information required by this item is contained under the section of the information statement entitled Management. That section is incorporated herein by reference.
Item 6. Executive Compensation.
The information required by this item is contained under the sections of the information statement entitled Compensation Discussion and Analysis, ManagementCompensation Committee Interlocks and Insider Participation and Director Compensation. Those sections are incorporated herein by reference.
Item 7. Certain Relationships and Related Transactions.
The information required by this item is contained under the sections of the information statement entitled Management and Certain Relationships and Related Person Transactions. Those sections are incorporated herein by reference.
Item 8. Legal Proceedings.
The information required by this item is contained under the section of the information statement entitled BusinessLegal Proceedings. That section is incorporated herein by reference.
Item 9. Market Price of, and Dividends on, the Registrants Common Equity and Related Stockholder Matters.
The information required by this item is contained under the sections of the information statement entitled Risk Factors, Dividend Policy, Capitalization, The Separation and Distribution and Description of Fortives Capital Stock. Those sections are incorporated herein by reference.
Item 10. Recent Sales of Unregistered Securities.
The information required by this item is contained under the sections of the information statement entitled Description of Material Indebtedness and Description of Fortives Capital StockSale of Unregistered Securities. Those sections are incorporated herein by reference.
Item 11. Description of Registrants Securities to Be Registered.
The information required by this item is contained under the sections of the information statement entitled Risk Factors, Dividend Policy, The Separation and Distribution and Description of Fortives Capital Stock. Those sections are incorporated herein by reference.
Item 12. Indemnification of Directors and Officers.
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The information required by this item is contained under the section of the information statement entitled Description of Fortives Capital StockLimitations on Liability, Indemnification of Officers and Directors and Insurance. That section is incorporated herein by reference.
Item 13. Financial Statements and Supplementary Data.
The information required by this item is contained under the section of the information statement entitled Index to Financial Statements and the financial statements referenced therein. That section is incorporated herein by reference.
Item 14. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.
None.
Item 15. Financial Statements and Exhibits.
(a) | Financial Statements and Schedule |
The information required by this item is contained under the section of the information statement entitled Index to Financial Statements and Schedule and the financial statements referenced therein. That section is incorporated herein by reference.
(b) | Exhibits |
See below.
The following documents are filed as exhibits hereto:
Exhibit |
Exhibit Description |
|
2.1 | Form of Separation and Distribution Agreement by and between Danaher Corporation and Fortive Corporation* | |
3.1 | Form of Amended and Restated Certificate of Incorporation of Fortive Corporation* | |
3.2 | Form of Amended and Restated Bylaws of Fortive Corporation* | |
10.1 | Form of Transition Services Agreement by and between Danaher Corporation and Fortive Corporation* | |
10.2 | Form of Employee Matters Agreement by and between Danaher Corporation and Fortive Corporation* | |
10.3 | Form of Tax Matters Agreement by and between Danaher Corporation and Fortive Corporation* | |
10.4 | Form of Intellectual Property Matters Agreement by and between Danaher Corporation and Fortive Corporation* | |
10.5 | Form of DBS License Agreement by and between Danaher Corporation and Fortive Corporation* | |
21.1 | Subsidiaries of Fortive Corporation* | |
99.1 | Information Statement of Fortive Corporation, preliminary and subject to completion, dated December 3, 2015** |
* | To be filed by amendment. |
** | Filed herewith. |
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SIGNATURES
Pursuant to the requirements of Section 12 of the Securities Exchange Act of 1934, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized.
Fortive Corporation |
||
By: |
/s/ James A. Lico |
|
Name: James A. Lico | ||
Title: President and Chief Executive Officer |
Date: December 3, 2015
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