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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CHAMBERS JOHN T 170 WEST TASMAN DRIVE SAN JOSE, CA 95134 |
X | Chairman and CEO |
/s/ John T. Chambers by Evan Sloves, Attorney-in-Fact | 06/14/2010 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Distribution, pursuant to the terms of the Chambers 2006 Annuity Trust Number Two, at its termination date, of the remaining assets of the Chambers 2006 Annuity Trust Number Two to the holders of the remainder interest thereunder. The distributees consist of two trusts, each for the benefit of a child of the reporting person. |
(2) | Includes 123,612 shares that were previously reported as indirectly beneficially owned by the Chambers 2006 Annuity Trust Number Two, which were distributed and became directly owned by the reporting person on May 30, 2010, pursuant to the terms of that trust which provide for annual annuity distributions from that trust to its grantor. |
(3) | These shares were previously reported as directly beneficially owned but were contributed to the Chambers 2013 GRAT #1 on May 25, 2010. |
(4) | These shares were previously reported as directly beneficially owned but were contributed to the Chambers 2015 GRAT #1 on May 25, 2010. |
(5) | These shares were previously reported as directly beneficially owned but were contributed to the Chambers 2017 GRAT #1 on May 25, 2010. |