Form: 3

Initial statement of beneficial ownership of securities

January 7, 2022

Documents

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*
Newcombe Tamara S.
(Last) (First) (Middle)
6920 SEAWAY BLVD.
(Street)
EVERETT WA 98203
(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2022 		3. Issuer Name and Ticker or Trading Symbol
Fortive Corp [ FTV ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President & CEO of PT
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 49,836(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
Employee Stock Option (Right to Buy) (2) 11/15/2031 Common Stock 19,840 78.03 D
Employee Stock Option (Right to Buy) (3) 02/24/2031 Common Stock 22,370 67.64 D
Employee Stock Option (Right to Buy) (4) 02/20/2030 Common Stock 18,931 63.85 D
Employee Stock Option (Right to Buy) (4) 05/15/2029 Common Stock 10,704 67.65 D
Employee Stock Option (Right to Buy) (4) 02/25/2029 Common Stock 14,132 67.85 D
Employee Stock Option (Right to Buy) (4) 02/22/2028 Common Stock 14,686 63.76 D
Employee Stock Option (Right to Buy) (4) 02/23/2027 Common Stock 60,594 47.61 D
Executive Deferred Incentive Program - Fortive Stock Fund(5) (6) (6) Common Stock 2,964.87 (7) D
Explanation of Responses:
1. Includes 36,021 Restricted Stock Units ("RSUs") held by the Reporting Person, with the RSUs subject to time-based vesting provisions and payable in shares of common stock on a one-to-one basis.
2. One half of the options granted vest on each of the third and fourth anniversary of the grant date.
3. Options vests ratably on an annual basis over a four-year period from the date of grant.
4. Options vests ratably on an annual basis over a five-year period from the date of grant.
5. The reported securities are phantom shares in the Fortive stock fund (the "EDIP Stock Fund") under Fortive's Executive Deferred Incentive Program (the "EDIP")
6. The Reporting Person immediately vests in 100% of each voluntary contribution to the EDIP Stock Fund. The Reporting Person will vest in all contributions to the EDIP Stock Fund by the Issuer as follows: 100% upon the earlier of the Reporting Person's death, or upon retirement following at least 5 years of service with the Issuer and reaching the age of 55, or, if earlier, one-tenth per year of participation following five years of participation, in each case in accordance with the EDIP. Upon termination of employment, the vested portion of the EDIP Stock Fund is settled in the Issuer's common stock.
7. The notional shares convert on a one-to-one basis.
Remarks:
Daniel B. Kim, as attorney-in-fact 01/07/2022
** 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.