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) 09/29/2004 |
3. Issuer Name and Ticker or Trading Symbol
PRIMUS GUARANTY LTD [ PRS ] |
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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 Shares, par value $.01 per share(1) | 600,000(2) | D |
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 | ||||
Options to Purchase Common Shares | 09/29/2004 | 02/15/2013 | Common Shares, par value $.01 per share(1) | 125,000(3) | $0.867 | D | |
Options to Purchase Common Shares | 09/29/2004 | 02/15/2014 | Common Shares, par value $.01 per share(1) | 100,000(4) | $1.22 | D | |
Options to Purchase Common Shares | 02/15/2006 | 02/15/2013 | Common Shares, par value $.01 per share(1) | 25,000 | $0.867 | D | |
Options to Purchase Common Shares | 02/15/2007 | 02/15/2014 | Common Shares, par value $.01 per share(1) | 50,000 | $1.22 | D | |
Options to Purchase Common Shares | 02/15/2007 | 02/15/2013 | Common Shares, par value $.01 per share(1) | 50,000 | $0.867 | D | |
Options to Purchase Common Shares | 02/15/2008 | 02/15/2014 | Common Shares, par value $.01 per share(1) | 50,000 | $1.22 | D | |
Restricted Share Units | 09/29/2004 | (7) | Common Shares, par value $.01 per share(1) | 143,664(5)(6) | (7) | D | |
Restricted Share Units | 02/15/2006 | (7) | Common Shares, par value $.01 per share(1) | 62,312(6) | (7) | D | |
Restricted Share Units | 02/15/2007 | (7) | Common Shares, par value $.01 per share(1) | 38,120(6) | (7) | D |
Explanation of Responses: |
1. Par value shall become $.08 per share upon completion of the initial public offering of Primus Guaranty, Ltd., reflecting a one for eight reverse share split to be effected immediately prior to such offering. |
2. Includes 600,000 restricted common shares, par value $.01 per share, of which 500,000 restricted common shares, par value $.01 per share, are vested and of which 100,000 restricted common shares, par value $.01 per share, will vest on May 6, 2005. |
3. Includes vested options to purchase 50,000 common shares, par value $.01 per share, and options to purchase 75,000 common shares, par value $.01 per share, that vest upon the completion of the initial public offering of Primus Guaranty, Ltd. |
4. Includes options to purchase 100,000 common shares, par value $.01 per share, that vest upon the completion of the initial public offering of Primus Guaranty, Ltd. |
5. Includes 43,248 vested restricted share units and 100,416 restricted share units that will vest upon completion of the initial public offering of Primus Guaranty, Ltd. |
6. Upon their vesting, restricted share units convert to the right to receive common shares. |
7. Not Applicable. |
/s/ ZACHARY SNOW | 09/29/2004 | |
** 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). | ||
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. |