SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
PERTZ DOUGLAS A

(Last) (First) (Middle)
100 SOUTH SAUNDERS ROAD
SUITE 300

(Street)
LAKE FOREST IL 60045

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MOSAIC CO [ MOS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/22/2004
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 10/22/2004 A 415,304.52 A (1) 415,304.52 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) $18.1875 10/22/2004 A 320,000 10/22/2004 08/28/2008 Common Stock 320,000 $18.1875(2) 320,000 D
Stock Option (right to buy) $18.1875 10/22/2004 A 180,000 10/22/2004 08/28/2008 Common Stock 180,000 $18.1875(2) 180,000 D
Stock Option (right to buy) $14.3125 10/22/2004 A 275,000 10/22/2004 10/01/2009 Common Stock 275,000 $14.3125(2) 275,000 D
Stock Option (right to buy) $15.0312 10/22/2004 A 254,000 10/22/2004 02/22/2010 Common Stock 254,000 $15.0312(2) 254,000 D
Stock Option (right to buy) $15.0625 10/22/2004 A 124,040 10/22/2004 03/30/2010 Common Stock 124,040 $15.0625(2) 124,040 D
Stock Option (right to buy) $13.55 10/22/2004 A 325,000 10/22/2004 02/28/2011 Common Stock 325,000 $13.55(2) 325,000 D
Stock Option (right to buy) $9.65 10/22/2004 A 175,000 10/22/2004 07/10/2011 Common Stock 175,000 $9.65(2) 175,000 D
Stock Option (right to buy) $12.99 10/22/2004 A 440,000 10/22/2004 01/02/2012 Common Stock 440,000 $12.99(2) 440,000 D
Stock Option (right to buy) $10.76 10/22/2004 A 310,000 10/22/2004 01/02/2013 Common Stock 310,000 $10.76(2) 310,000 D
Stock Option (right to buy) $10.19 10/22/2004 A 445,000 10/22/2004 01/02/2014 Common Stock 445,000 $10.19(2) 445,000 D
Explanation of Responses:
1. Received in exchange for 502,359.52 shares of IMC Global Inc. common stock with merger of IMC Global (the "Merger"). On the effective date of the Merger, the closing price of IMC Global's common stock was $15.00 per share.
2. Received in the Merger in exchange for a stock option to acquire the same number of IMC Global common stock at the same price per share.
s/Richard L. Mack 10/26/2004
** 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.