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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/12/2006 |
3. Issuer Name and Ticker or Trading Symbol
ACME PACKET INC [ APKT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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, $0.001 par value | 98,600 | D | |
Common Stock, $0.001 par value | 87,000 | I | By Spouse(1) |
Common Stock, $0.001 par value | 14,400 | I | By Spouse, as Trustee(2) |
Common Stock, $0.001 par value | 2,000,000 | I | By The Ory Family Trust(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Series A Convertible Preferred Stock | 09/21/2000 | (4) | Common Stock | 478,523 | (4) | D | |
Series B Convertible Preferred Stock | 06/28/2002 | (4) | Common Stock | 79,137 | (4) | I | By Spouse(1) |
Series B Convertible Preferred Stock | 06/15/2003 | (4) | Common Stock | 35,972 | (4) | I | By Spouse(1) |
Series C Convertible Preferred Stock | 06/08/2004 | (4) | Common Stock | 53,476 | (4) | I | By Spouse(1) |
Explanation of Responses: |
1. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for the purposes of Section 16 or for any other purpose. |
2. The spouse of the reporting person is a trustee of The Ory 2006 Grandchildren's Trust f/b/o Benjamin J. Ory dtd 8/21/06, The Ory 2006 Granchildren's Trust f/b/o Samatha L. Ory dtd 8/21/06 and the The Ory 2006 Grandchildren's Trust f/b/o Sara S. Ory dtd 8/21/06, each established for the benefit of his grandchildren, and the spouse of reporting person exercises voting and investment control over the shares. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for the purposes of Section 16 or for any other purpose. |
3. The reporting person is a trustee of The Ory Family Trust, established for the benefit of his grandchildren, and the reporting person exercises shared voting and investment control over the shares. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for the purposes of Section 16 or for any other purpose. |
4. Each of the Series A Convertible Preferred Stock, the Series B Convertible Preferred Stock and the Series C Convertible Preferred Stock is convertible into Acme Packet, Inc. common stock on an one-for one basis and has no expiration date. |
/s/ Robert G. Ory | 10/12/2006 | |
** 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). | ||
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. |