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) 10/28/2004 |
3. Issuer Name and Ticker or Trading Symbol
DreamWorks Animation SKG, Inc. [ DWA ] |
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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) |
Class A Common Stock | 12,627,933 | I(1) | See Footnote 1(1) |
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 | ||||
Class B Common Stock | (2) | (2) | Class A Common Stock | 49,688,334 | (2) | I(3) | See Footnote 3(3) |
Class C Common Stock | (4) | (4) | Class A Common Stock | 1 | (4) | I(1) | See Footnote 1(1) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. These securities are held directly by DW Investment II, Inc. ("DWI II"), which is wholly owned by Paul G. Allen. Paul G. Allen is an indirect beneficial owner of these securities. |
2. These securities will convert into DreamWorks Animation SKG Inc. Class A Common Stock ("Class A Stock") on a one-for-one basis automatically upon the distribution of these securities to any person other than certain specified partners in DWA Escrow (which group of specified partners does not include any of the reporting persons). |
3. These securities are held directly by DWA Escrow LLLP ("DWA Escrow"). DWI II (and, indirectly, Paul G. Allen) may be deemed to share investment control of DWA Escrow and to be the indirect beneficial owner of these securities. Each reporting person disclaims beneficial ownership of these securities except to the extent of his or its pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. |
4. This security will convert into one share of Class A Stock automatically upon any sale or other transfer by DWI II (other than to certain affiliates of DWI II). |
Remarks: |
/s/ W. Lance Conn, Attorney-in-Fact for Paul G. Allen | 10/28/2004 | |
DW Investment II, Inc., By: /s/ W. Lance Conn, Vice President | 10/28/2004 | |
** 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. |