-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, SdX64p/poSiwrEiD4Wt+LPdFU3rU6sIdbS6k5E1cvuqNeUiu/2tB0IxwiHoGBC27 ezzBmZXuBgnNUB1pePVv5g== 0000902269-03-000006.txt : 20030130 0000902269-03-000006.hdr.sgml : 20030130 20030129205104 ACCESSION NUMBER: 0000902269-03-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030129 FILED AS OF DATE: 20030130 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: KATZIN JEROME S CENTRAL INDEX KEY: 0001191325 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 5775 MOREHOUSE DR CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: 8586514394 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: QUALCOMM INC/DE CENTRAL INDEX KEY: 0000804328 STANDARD INDUSTRIAL CLASSIFICATION: RADIO & TV BROADCASTING & COMMUNICATIONS EQUIPMENT [3663] IRS NUMBER: 953685934 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19528 FILM NUMBER: 03530819 BUSINESS ADDRESS: STREET 1: 5775 MOREHOUSE DR CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: 8585871121 MAIL ADDRESS: STREET 1: 5775 MOREHOUSE DR CITY: SAN DIEGO STATE: CA ZIP: 92121 4 1 katzin4-012903.txt 4 1 NASDAQ 0001191325 Director QUALCOMM Incorporated 0000804328 95-3685934 01/29/03 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. 1. Name and Address of Reporting Person(s) Katzin, Jerome S. 5775 Morehouse Dr. San Diego, CA 92121-1714 2. Issuer Name and Ticker or Trading Symbol QUALCOMM Incorporated (QCOM) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Day/Year 1/29/2003 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) 7. 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 Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Security 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code V Amount D Price End of Month I - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 300,000 I by GRATS Common Stock 01/29/03 M 10,000 A $4.23 I by Trust (1) Common Stock 01/29/03 M 15,000 A $2.78 I by Trust (1) Common Stock 01/29/03 S 25,000 D $38.00 690,128 I by Trust (1) Table II (PART 1) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code V A D Exercisable Expiration - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option $2.78 01/29/03 M 15,000 (2) 02/15/04 (right to buy) Non-Qualified Stock Option $4.23 01/29/03 M 10,000 (3) 07/26/03 (right to buy) Table II (PART 2) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Month - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option 01/29/03 Common Stock 15,000 225,000 D Direct (right to buy) Non-Qualified Stock Option 01/29/03 Common Stock 10,000 0 D Direct (right to buy) Explanation of Responses: (1) Securities held by Jerome S. Katzin and Miriam Katzin Trustees Under the Katzin Revocable Family Trust dtd. 10/27/79. (2) Stock options granted under the Company's Non-Employee Directors' Stock Option Plan. The options vest at the rate of 20% on Februar y 16, 1996, 20% on February 16, 1997, 20% on February 16, 1998, and 40% on February 16, 1999. (3) Stock options granted under the Company's Non-Employee Directors' Stock Option Plan. The options vest at the rate of 20% on July 27 , 1995, 20% on July 27, 1996, 20% on July 27, 1997, and 40% on July 27, 1998.
SIGNATURE OF REPORTING PERSON /S/ By: Noreen E. Burns, Attorney-in-Fact For: Jerome S. Katzin DATE 01/29/03
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