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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 | ||||||||
Non-Qualified Stock Option (right to buy) | $ 14.28 | 03/26/2009 | D | 180,000 (3) | 09/12/2002(4) | 09/12/2012 | Common Stock | 180,000 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 20.9 | 03/26/2009 | D | 106,400 (3) | 09/26/2001(4) | 09/26/2011 | Common Stock | 106,400 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 42.05 | 03/26/2009 | D | 132,000 (3) | 09/11/2003(4) | 09/11/2013 | Common Stock | 132,000 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 53.23 | 03/26/2009 | D | 150,000 (3) | 09/23/2004(4) | 09/23/2014 | Common Stock | 150,000 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 79.17 | 03/26/2009 | D | 135,000 (3) | 09/20/2007(4) | 09/20/2016 | Common Stock | 135,000 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 79.55 | 03/26/2009 | D | 125,000 (3) | 09/20/2008(4) | 09/20/2017 | Common Stock | 125,000 | $ 0 (5) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 85.83 | 03/26/2009 | D | 157,500 (3) | 09/23/2005(4) | 09/23/2015 | Common Stock | 157,500 | $ 0 (5) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
EBERSMAN DAVID A 1 DNA WAY SO SAN FRANCISCO, CA 94080 |
EVP & CHIEF FINANCIAL OFFICER |
By: ADAM B. LAUTNER For: DAVID A. EBERSMAN | 03/30/2009 | |
**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) | Disposed of pursuant to the Agreement and Plan of Merger between the issuer, Roche Holdings Inc. and Roche Investments USA dated March 12, 2009. |
(2) | Shares held in the Ebersman Family Trust UAD 5/29/02, for which the reporting person is a co-trustee and beneficiary along with his spouse. |
(3) | At the effective time of the merger, this option vested in full and was cancelled in exchange for a cash amount equal to the net value of the exercise price and the merger consideration. |
(4) | At the effective time of the merger, this option vested in full and was cancelled in exchange for a cash amount equal to the net value of the exercise price and the merger consideration. |
(5) | At the effective time of the merger, this option vested in full and was cancelled in exchange for a cash amount equal to the net value of the exercise price and the merger consideration. |