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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Incentive Stock Option (right to buy) | $ 6.5 | 08/15/2011 | M | 2,077 | (4) | 09/06/2011 | Common Stock | 2,077 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MERKADEAU STUART L 7005 SOUTHFRONT ROAD LIVERMORE, CA 94551 |
SR VP GENERAL COUNSEL |
By: /s/ Henry I. Feir, Attorney-in-Fact For: Stuart L. Merkadeau | 08/16/2011 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Stock sold was acquired as a result of vested shares of common stock issued pursuant to the first conversion of one-fourth of the restricted stock units granted on April 29, 2010. The vested restricted stock units were settled in shares of common stock on April 29, 2011. |
(2) | On July 29, 2011, Mr. Merkadeau acquired 1 share from FormFactor through the 2002 Employee Stock Purchase Plan. The amount of shares beneficially owned by Mr. Merkadeau includes the acquisition of such share. |
(3) | Stock sold was acquired as a result of vested shares of common stock issued pursuant to the second conversion of one-fourth of the restricted stock units granted on May 20, 2009. The vested restricted stock units were settled in shares of common stock on May 20, 2011. |
(4) | The option, which is immediately exercisable, was fully vested on September 6, 2001. |
Remarks: THE CONFIRMING STATEMENT GRANTING THE ATTORNEY-IN-FACT THE AUTHORITY TO EXECUTE AND FILE THIS FORM 4 HAS BEEN PREVIOUSLY FILED WITH THE U.S. SECURITIES AND EXCHANGE COMMISSION. |