0000796343-17-000184.txt : 20171207 0000796343-17-000184.hdr.sgml : 20171207 20171207162154 ACCESSION NUMBER: 0000796343-17-000184 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171201 FILED AS OF DATE: 20171207 DATE AS OF CHANGE: 20171207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BURGESS ROBERT K CENTRAL INDEX KEY: 0001198782 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-15175 FILM NUMBER: 171244985 BUSINESS ADDRESS: STREET 1: 600 TOWNSEND ST STREET 2: STE 310 W CITY: SAN FRANCISCO STATE: CA ZIP: 94103 BUSINESS PHONE: 4152522000 MAIL ADDRESS: STREET 1: MACROMEDIA/ 600 TOWNSEND ST CITY: SAN FRANCISCO STATE: CA ZIP: 94103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ADOBE SYSTEMS INC CENTRAL INDEX KEY: 0000796343 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 770019522 STATE OF INCORPORATION: DE FISCAL YEAR END: 1202 BUSINESS ADDRESS: STREET 1: 345 PARK AVE CITY: SAN JOSE STATE: CA ZIP: 95110-2704 BUSINESS PHONE: 4085366000 MAIL ADDRESS: STREET 1: 345 PARK AVENUE CITY: SAN JOSE STATE: CA ZIP: 95110-2704 5 1 wf-form5_151268170041957.xml FORM 5 X0306 5 2017-12-01 0 0 0 0000796343 ADOBE SYSTEMS INC ADBE 0001198782 BURGESS ROBERT K ADOBE SYSTEMS INCORPORATED 345 PARK AVENUE SAN JOSE CA 95110 1 0 0 0 Common Stock 27550 I by trust Common Stock 12375 D Includes 25,930 shares held by The Burgess Family Trust, dtd 07/23/98 of which reporting person is a trustee, and 1,620 shares in trust for the benefit of Mr. Burgess' children. /s/ Jonathan Vaas, as attorney-in-fact 2017-12-07