FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
|
|||||||||||||||
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
FORMFACTOR INC [ FORM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
3. Date of Earliest Transaction
(Month/Day/Year) 10/25/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 08/19/2004 | J | 12,358 | D | $0 | 0 | D | |||
Common Stock | 08/04/2004 | J | 4,880 | D | $0 | 13,941 | I | By Self, Trustee ACE | ||
Common Stock | 08/04/2004 | J | 13,941 | D | $0 | 0 | I | By Self, Trustee ACE | ||
Common Stock | 08/04/2004 | J | 4,880 | D | $0 | 13,941 | I | By Self, Trustee GCE | ||
Common Stock | 08/04/2004 | J | 13,941 | D | $0 | 0 | I | By Self, Trustee GCE | ||
Common Stock | 08/04/2004 | J | 13,941 | A | $0 | 13,941 | I | Children's IRR TR I(1) | ||
Common Stock | 08/04/2004 | J | 13,941 | A | $0 | 13,941 | I | Children's IRR TR II(2) | ||
Common Stock | 10/25/2004 | S | 13,941 | D | $21.9961 | 0 | I | Children's IRR TR II(3) | ||
Common Stock | 08/04/2004 | J | 4,880 | A | $0 | 4,880 | I | Everett Family Trust | ||
Common Stock | 08/04/2004 | J | 4,880 | A | $0 | 9,760 | I | Everett Family Trust | ||
Common Stock | 08/19/2004 | J | 12,358 | A | $0 | 22,118 | I | Everett Family Trust(4) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. GCE 2002 Retained Annuity Trust for which the Reporting Person served as trustee transferred on 8/04/04 13,941 shares to The Everett Children's Irrevocable Trust I for which the Reporting Person serves as trustee. |
2. ACE 2002 Retained Annuity Trust for which the Reporting Person's spouse served as trustee transferred on 8/04/04 13,941 shares to The Everett Children's Irrevocable Trust II for which the Reporting Person's spouse serves as trustee. |
3. The Reporting Person is filing this Form 4 to report the sale of 13,941 shares by The Everett Children's Irrevocable Trust II on 10/25/04. |
4. The 22,118 shares are held by the Everett Family Revocable Trust for which the Reporting Person serves as trustee with his wife. Of these shares, 4,880 were acquired from the ACE 2002 Retained Annuity Trust on 8/4/04, 4,880 were acquired from the GCE 2002 Retained Annuity Trust on 8/4/04 and 12,358 were acquired from the Reporting Person on 8/19/04. |
By: Gail Chin, Attorney-in-Fact For: G. Carl Everett | 10/27/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |