SEC Form 5

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Check this box if no longer subject

Washington, D.C. 20549

OMB APPROVAL

to Section 16. Form 4 or Form 5

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL

OMB Number:

3235-0362

obligations may continue. See

Instruction 1(b).

OWNERSHIP

Estimated average burden

Form 3 Holdings Reported.

hours per response:

1.0

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934

Form 4 Transactions Reported.

or Section 30(h) of the Investment Company Act of 1940

1. Name and Address of Reporting Person*

2. Issuer Name and Ticker or Trading Symbol

5. Relationship of Reporting Person(s) to Issuer

LEWIS EARL R

FLIR SYSTEMS INC[ FLIR ]

(Check all applicable)

X Director

10% Owner

3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)

Officer (give title

Other (specify

(Last)

(First)

(Middle)

below)

below)

12/31/2020

27700 SW PARKWAY AVENUE

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable

(Street)

Line)

X Form filed by One Reporting Person

WILSONVILLE OR

97070

Form filed by More than One Reporting

Person

(City)

(State)

(Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security (Instr. 3)

2. Transaction

2A. Deemed

3.

4. Securities Acquired (A) or Disposed

5. Amount of

6.

7. Nature of

Date

Execution Date,

Transaction

Of (D) (Instr. 3, 4 and 5)

Securities

Ownership

Indirect

(Month/Day/Year)

if any

Code (Instr.

Beneficially

Form: Direct

Beneficial

(Month/Day/Year)

8)

Owned at end of

(D) or

Ownership

(A) or

Issuer's Fiscal

Indirect (I)

(Instr. 4)

Amount

Price

Year (Instr. 3 and

(Instr. 4)

(D)

4)

Common Stock

03/03/2020

G

20,000

D

$0

30,000

I

Children's

Trust

Common Stock

525,826

D

Common Stock

176,832

I

Spouse

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned

(e.g., puts, calls, warrants, options, convertible securities)

1. Title of

2.

3. Transaction

3A. Deemed

4.

5. Number

6. Date Exercisable and

7. Title and

8. Price of

9. Number of

10.

11. Nature

Derivative

Conversion

Date

Execution Date,

Transaction

of

Expiration Date

Amount of

Derivative

derivative

Ownership

of Indirect

Security

or Exercise

(Month/Day/Year)

if any

Code (Instr.

Derivative

(Month/Day/Year)

Securities

Security

Securities

Form:

Beneficial

(Instr. 3)

Price of

(Month/Day/Year)

8)

Securities

Underlying

(Instr. 5)

Beneficially

Direct (D)

Ownership

Derivative

Acquired

Derivative

Owned

or Indirect

(Instr. 4)

Security

(A) or

Security (Instr.

Following

(I) (Instr. 4)

Disposed

3 and 4)

Reported

of (D)

Transaction(s)

(Instr. 3, 4

(Instr. 4)

and 5)

Amount

or

Date

Expiration

Number

(A)

(D)

Title

of

Exercisable

Date

Shares

Explanation of Responses:

Remarks:

/s/ Sonia Galindo, Attorney-

01/22/2021

in-fact for Earl R. Lewis

** 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 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). 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.

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FLIR Systems Inc. published this content on 22 January 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 22 January 2021 13:21:05 UTC