-----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, OEGRAXreWR78xYtdPJuUqXU4rqnRBFtIinenBaUYO/DiGwemwU0opwQelseDC86M iHf0KCu7/eA6HljrmwE7Ug== 0001185116-02-000009.txt : 20021001 0001185116-02-000009.hdr.sgml : 20021001 20020930191502 ACCESSION NUMBER: 0001185116-02-000009 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020927 FILED AS OF DATE: 20021001 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: BARNES MICHAEL W CENTRAL INDEX KEY: 0001185116 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 2280 N. GREENVILLE AVE. CITY: RICHARDSON STATE: TX ZIP: 75082 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FOSSIL INC CENTRAL INDEX KEY: 0000883569 STANDARD INDUSTRIAL CLASSIFICATION: WATCHES, CLOCKS, CLOCKWORK OPERATED DEVICES/PARTS [3873] IRS NUMBER: 752018505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19848 FILM NUMBER: 02777435 BUSINESS ADDRESS: STREET 1: 2280 NORTH GREENVILLE AVE CITY: RICHARDSON STATE: TX ZIP: 75082 BUSINESS PHONE: 9722342525 MAIL ADDRESS: STREET 1: 2280 N GREENVILLE CITY: RICHARDSON STATE: TX ZIP: 75082 4 1 mbsept272002form4.txt MBSEPT272002FORM4 1. Name and Address of Reporting Person BARNES, MICHAEL W. 2280 N. Greenville Richardson, TX 75082 2. Issuer Name and Ticker or Trading Symbol Fossil Inc. (FOSL) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 9/27/2002 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Divisonal President 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. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ +-------+-----+-----------+------+----------+ Month | Indirect| Owner- | | | Year) |Code |V |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------+-----+-----------+------+----------+----------------+-----------+------------+ Common Stock 09/27/2002 S -4252 D $20.2000 153808 D Common Stock 1012 I Independent Administrator of Estate
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ +------+--+-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) |Code |V |(A) |(D) |cisable |tion Date |Title |Shares |Security |Month |(I) |ship | +-------------+--------+----------+------+--+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Stock Options $0.6666 01/01/2010 Common 35000 D (Right to buy) Stock Stock Options $7.4584 10/25/2010 Common 52499 D (Right to buy) Stock Stock Options $10.6667 02/02/2010 Common 22500 D (Right to buy) Stock Stock Options $12.0278 02/12/2009 Common 28897 D (Right to buy) Stock Stock Options $13.8334 01/14/2012 Common 52500 D (Right to buy) Stock Explanation of Responses: Mr. Barnes acquired voting control of these securites as independent administrator pursuant to letters testamentary executed on September 25, 2002.
SIGNATURE OF REPORTING PERSON /s/ MICHAEL W. BARNES DATE 09/30/2002 -----END PRIVACY-ENHANCED MESSAGE-----