FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/09/2004 |
3. Issuer Name and Ticker or Trading Symbol
MBIA INC [ MBI ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 907.42(1) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Employee Stock Option (Right to Buy) | 12/07/1997 | 12/07/2005 | Common Stock | 954(2) | $25.71 | D | |
Employee Stock Option (Right to Buy) | 12/04/1998 | 12/04/2006 | Common Stock | 1,800(2) | $33.96 | D | |
Employee Stock Option (Right to Buy) | 12/11/1999 | 12/11/2007 | Common Stock | 1,485(2) | $42.79 | D | |
Employee Stock Option (Right to Buy) | 12/09/2000 | 12/09/2008 | Common Stock | 2,670(2) | $42.5 | D | |
Employee Stock Option (Right to Buy) | 12/09/2001 | 12/09/2009 | Common Stock | 3,765(2) | $32.54 | D | |
Employee Stock Option (Right to Buy) | 12/12/2002 | 12/12/2010 | Common Stock | 4,185(2) | $48.58 | D | |
Employee Stock Option (Right to Buy) | 02/07/2004 | 02/07/2012 | Common Stock | 4,400(2) | $52.81 | D | |
Employee Stock Option (Right to Buy) | 02/12/2005 | 02/12/2013 | Common Stock | 4,000(2) | $36.69 | D | |
Employee Stock Option (Right to Buy) | 02/10/2005 | 02/10/2014 | Common Stock | 4,000(3) | $64.84 | D | |
Employee Stock Option (Right to Buy) | 10/07/2007 | 10/07/2012 | Common Stock | 10,000(4) | $36.72 | D | |
Employee Stock Option (Right to Buy) | 06/09/2009 | 06/09/2014 | Common Stock | 60,000(5) | $55.6 | D |
Explanation of Responses: |
1. Shares acquired prior to status as Reporting Person including a) 750 shares of restricted stock granted at $64.84 and vesting entirely in December 2008, and b) 157.42 shares held in Employee 401(k) Plan. |
2. Options granted prior to status as a Reporting Person. Grant of options exempt under 16b-3 with 5 year gradual vesting: 0% on first anniversary; 40% on second anniversary; 20% each on third, fourth and fifth anniversary of the grant. |
3. Options granted prior to status as a Reporting Person. Grant of options exempt under 16b-3 with vesting 25% on first anniversary; and 25% on second, third and fourth anniversary of grant. |
4. Options granted prior to status as a Reporting Person. Options have cliff vesting - 100% on 5th anniversary of grant. |
5. Grant of options having cliff vesting - 100% vested on 5th anniversary of grant. |
LEONARD I. CHUBINSKY AS ATTORNEY IN FACT | 06/22/2004 | |
** 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 5 (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. |