SEC Form 3
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*
Novak Rodd

(Last) (First) (Middle)
C/O PEREGRINE SEMICONDUCTOR CORPORATION
9380 CARROLL PARK DRIVE

(Street)
SAN DIEGO CA 92121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/07/2012
3. Issuer Name and Ticker or Trading Symbol
PEREGRINE SEMICONDUCTOR CORP [ PSMI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Marketing Officer
5. 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 Beneficially Owned
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)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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) (1) 06/09/2014 Common Stock 567 0.73 D
Employee Stock Option (Right to Buy) (2) 06/09/2014 Common Stock 3,405 0.73 D
Employee Stock Option (Right to Buy) (3) 06/09/2014 Common Stock 6,811 0.73 D
Employee Stock Option (Right to Buy) (4) 11/19/2014 Common Stock 13,623 0.73 D
Employee Stock Option (Right to Buy) (5) 05/19/2015 Common Stock 1,231 0.88 D
Employee Stock Option (Right to Buy) (6) 05/19/2015 Common Stock 10,217 0.88 D
Employee Stock Option (Right to Buy) (7) 05/19/2015 Common Stock 6,130 0.88 D
Employee Stock Option (Right to Buy) (8) 05/25/2016 Common Stock 10,899 1.76 D
Employee Stock Option (Right to Buy) (9) 01/31/2018 Common Stock 13,269 1.76 D
Employee Stock Option (Right to Buy) (10) 01/31/2018 Common Stock 20,379 1.76 D
Employee Stock Option (Right to Buy) (11) 05/28/2019 Common Stock 34,059 1.76 D
Employee Stock Option (Right to Buy) (12) 05/28/2019 Common Stock 34,059 1.76 D
Employee Stock Option (Right to Buy) (13) 05/28/2019 Common Stock 40,871 1.76 D
Employee Stock Option (Right to Buy) (14) 01/28/2020 Common Stock 20,435 5.73 D
Employee Stock Option (Right to Buy) (15) 07/22/2020 Common Stock 40,871 7.12 D
Employee Stock Option (Right to Buy) (16) 10/25/2021 Common Stock 20,435 9.76 D
Employee Stock Option (Right to Buy) (17) 01/30/2013 Common Stock 3,405 0.73 D
Explanation of Responses:
1. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 12 successive equal monthly installments from April 1, 2006.
2. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 12 successive equal monthly installments from April 1, 2007.
3. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 48 successive equal monthly installments from April 1, 2004.
4. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 48 successive equal monthly installments from November 19, 2004.
5. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 12-month period from November 19, 2008.
6. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 12 successive equal monthly installments from April 1, 2009.
7. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 12 successive equal monthly installments from April 1, 2008.
8. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 48 successive equal monthly installments from May 25, 2006.
9. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 26-month period from February 1, 2008.
10. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 12-month period from April 1, 2010.
11. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 12-month period from March 31, 2011.
12. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 12-month period from March 31, 2012.
13. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in successive equal daily installments over a 36-month period from May 28, 2009.
14. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses in 38 successive equal monthly installments from February 1, 2010.
15. Subject to continuous service, the option is exercisable in successive equal daily installments over a 12-month period from April 1, 2013.
16. Subject to continuous service, the option is exercisable in 12 successive equal monthly installments from April 1, 2014.
17. Subject to continuous service, this option is immediately exercisable for all shares. Any shares acquired upon exercise are subject to a right of repurchase at the original exercise price per share. The right of repurchase lapses with respect to 25% of the shares to this option on January 6, 2004 and in equal monthly installments over a 36-month period of the remaining shares subject to this option thereafter.
/s/ Jay Biskupski as Attorney-in-fact for Rodd E. Novak 08/07/2012
** 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.
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