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*
Rubottom Kimberly J.

(Last) (First) (Middle)
C/O GARDNER DENVER HOLDINGS, INC.,
222 EAST ERIE STREET, SUITE 500

(Street)
MILWAUKEE WI 53202

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/11/2017
3. Issuer Name and Ticker or Trading Symbol
GARDNER DENVER HOLDINGS, INC. [ GDI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP, Human Resources
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 8,572 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 Options (Right to Buy) (1) 03/19/2024 Common Stock 67,661 $8.16 D
Stock Options (Right to Buy) (2) 12/01/2026 Common Stock 14,132 $11.43 D
Explanation of Responses:
1. Of this stock option award, 50,745 stock options are currently vested, with an additional 33,831 stock options eligible to vest in equal installments on each of December 31, 2017 and December 31, 2018, where 50% of such unvested options are eligible to vest on such dates, or later dates, subject to the satisfaction of future performance-based vesting conditions and are not included in the table above.
2. Of this stock option award, 4,710 stock options are currently vested, with an additional 18,843 stock options eligible to vest in equal installments on each of December 31, 2017, December 31, 2018, December 31, 2019 and December 31, 2020, where 50% of such unvested options are eligible to vest on such dates, or later dates, subject to the satisfaction of future performance-based vesting conditions and are not included in the table above.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
/s/ Andrew Schiesl, as Attorney-in-Fact 05/11/2017
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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