5 1 jacobsson.txt ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) JACOBSSON, JACOB S. 955 East Arques Avenue Sunnyvale, CA 94086-4533 2. Issuer Name and Ticker or Trading Symbol ACTEL CORPORATION (ACTL) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 01/03 5. If Amendment, Date of Original (Month/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 Amount D Price End of Year I ------------------------------------------------------------------------------------------------------------------------------------ Table II (PART 1) Derivative Securitites 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 A D Exercisable Expiration ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option $12.8750 05/22/08 (right to buy) Non-Qualified Stock Option $14.5000 08/01/02 A 5,000 08/01/12 (right to buy) Non-Qualified Stock Option $15.0000 08/01/09 (right to buy) Non-Qualified Stock Option $23.8000 08/01/11 (right to buy) Non-Qualified Stock Option $35.5000 08/01/10 (right to buy) Table II (PART 2) Derivative Securitites 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 Year ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option Common Stock 15,000 15,000 D Direct (right to buy) Non-Qualified Stock Option 08/01/02 Common Stock 5,000 5,000 D Direct (right to buy) Non-Qualified Stock Option Common Stock 5,000 5,000 D Direct (right to buy) Non-Qualified Stock Option Common Stock 5,000 5,000 D Direct (right to buy) Non-Qualified Stock Option Common Stock 5,000 5,000 D Direct (right to buy) Explanation of Responses:
SIGNATURE OF REPORTING PERSON /S/ JACOBSSON, JACOB S. DATE 02/10/03