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OMB APPROVAL
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OMB Number 3235-0362
Expires September 30, 1998
Estimated average
burden hours per
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 5
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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(f) of the Investment Company Act of 1940
[_] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
[_] Form 3 Holdings Reported
[_] Form 4 Transactions Reported
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1. Name and Address of Reporting Person
KAHN STEPHEN R.
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(Last) (First) (Middle)
PanAmSat Corporation
20 Westport Road
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(Street)
Wilton Connecticut 06897
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
PanAmSat Corporation (SPOT)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
December, 2001
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Reporting
(Check applicable line)
[X] Form Filed by one Reporting Person
[_] Form Filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5. 6.
4. Amount of Owner-
Securities Acquired (A) or Securities ship
Disposed of (D) Beneficially Form: 7.
(Instr. 3, 4 and 5) Owned at End Direct Nature of
2. 3. ----------------------------- of Issuer's (D) or Indirect
1. Transaction Transaction (A) Month Indirect Beneficial
Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) Month/Day/Year (Instr. 8) (D) and 4) (Instr.4) (Instr. 4)
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Common Stock, par value $0.01 per
share 3/01/01 A 1,304(1) A 3,073 D
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* If the form is filed by more than one reporting person, see instruction
4(b)(v).
(Print or Type Responses)
(Over)
SEC 2270 (7/96)
FORM 5 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- Securities Date Securities Price Bene- ity: In-
cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship
Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Explanation of Responses: (1) Reflects director fees paid in restricted shares
which vest on March 1, 2002.
By: James Cuminale, Attorney-in-Fact February 8, 2002
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Stephen R. Kahn Date
By: James W. Cuminale, Attorney-in-Fact
** 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.
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