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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
INTEVAC INC [ IVAC ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/12/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 11/10/2003 | M | 10,000 | A | $6 | 16,765 | D | |||
Common Stock | 11/10/2003 | C | 5,714 | A | $7 | 22,479 | D | |||
Common Stock | 11/11/2003 | M | 10,000 | A | $6 | 32,479 | D | |||
Common Stock | 11/11/2003 | S | 10,000 | D | $16.928 | 22,479 | D | |||
Common Stock | 11/12/2003 | S | 10,000 | D | $17.181 | 12,479 | D | |||
Common Stock | 84,141 | I | by Trust(1) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Convertible Subordinated Notes II | $7 | 11/10/2003(2) | C | $40,000 | 10/10/2002(3) | 03/01/2009 | Common Stock | $5,714 | (2) | $0 | D | ||||
Incentive Stock Option (right to buy) | $6 | 11/10/2003 | M | 10,000 | (4) | 08/07/2005 | Common Stock | 10,000 | $6 | 43,333 | D | ||||
Incentive Stock Option (right to buy) | $6 | 11/11/2003 | M | 10,000 | (4) | 08/07/2005 | Common Stock | 10,000 | $6 | 33,333 | D |
Explanation of Responses: |
1. Includes 84,141 shares held by the Eddy Family Trust DTD 02/09/00. |
2. The Convertible Notes due 2009 were automatically converted to common stock on November 10, 2003 at a conversion price of $7.00 per share. |
3. The holder of the Convertible Note has the right, exercisable at any time after 90 days following the date of original issuance of any Convertible Notes and prior to maturity, to convert the principal amount thereof into shares of Common Stock at the conversion price. |
4. The option is immediately exercisable, but any shares purchased under the option are subject to repurchase by the issuer at the option exercise price, upon the reporting person's termination of employment prior to vesting in the shares. The option shares vest in five successive equal installments upon the optionee's completion of each year of service over the five-year period measured from the grant date. |
Eddy, Charles B. | 11/12/2003 | |
** 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. |