SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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1. Name and Address of Reporting Person*
Mittermaier Richard

(Last) (First) (Middle)
7005 SOUTHFRONT ROAD

(Street)
LIVERMORE CA 94551

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/10/2004
3. Issuer Name and Ticker or Trading Symbol
FORMFACTOR INC [ FORM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Director of Accounting
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 349 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Incentive Stock Option (right to buy) 11/16/2000(1) 11/16/2010 Common Stock 8,454 6 D
Incentive Stock Option (right to buy) 10/30/2001(2) 10/30/2011 Common Stock 3,240 6.5 D
Incentive Stock Option (right to buy) 04/17/2002(3) 04/17/2012 Common Stock 3,500 6.5 D
Incentive Stock Option (right to buy) (4) 08/14/2013 Common Stock 3,413 19.5 D
Explanation of Responses:
1. The option, which is immediately exercisable, vests with respect to 25% of the shares on November 13, 2001 and thereafter continues to vest over a three-year period in equal monthly installments.
2. The option, which is immediately exercisable, vests over a one-year period in equal monthly installments, starting November 13, 2004.
3. The option, which is immediately exercisable, vests over a one-year period in equal monthly installments, starting November 13, 2005.
4. The option, which is exercisable as it vests, vests over a one-year period in equal monthly installments. The first 2,625 shares start vesting on November 13, 2006 and the remaining 788 shares start vesting on November 13, 2007.
By: Stuart L. Merkadeau, Attorney-in-Fact For: Richard Mittermaier 11/17/2004
** 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 5 (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).
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