-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, HU5ODtGm3PT7qdwHFNe/8MANoe0ppjyuJHZ1kxy0F0Gc8Rodhq8mnPed2zYhW527 fxCBM1V5y1PSrrFQ+Lc6zw== 0001234452-09-000367.txt : 20091005 0001234452-09-000367.hdr.sgml : 20091005 20091005184346 ACCESSION NUMBER: 0001234452-09-000367 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090927 FILED AS OF DATE: 20091005 DATE AS OF CHANGE: 20091005 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBS IRWIN M CENTRAL INDEX KEY: 0000902269 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19528 FILM NUMBER: 091106709 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QUALCOMM INC/DE CENTRAL INDEX KEY: 0000804328 STANDARD INDUSTRIAL CLASSIFICATION: RADIO & TV BROADCASTING & COMMUNICATIONS EQUIPMENT [3663] IRS NUMBER: 953685934 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 5775 MOREHOUSE DR CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: 8585871121 MAIL ADDRESS: STREET 1: 5775 MOREHOUSE DR CITY: SAN DIEGO STATE: CA ZIP: 92121 5 1 edgardoc.xml PRIMARY DOCUMENT X0303 5 2009-09-27 0 0 0 0000804328 QUALCOMM INC/DE QCOM 0000902269 JACOBS IRWIN M 5775 MOREHOUSE DR. SAN DIEGO CA 92121-1714 1 0 0 0 Common Stock 2009-09-10 5 M 0 28777 1 A 28777 D Common Stock 2009-09-10 5 S 0 11945 46.2301 D 16832 D Common Stock 8696038 I By GRAT Common Stock 8696038 I by GRAT S Common Stock 5586083 I by Trust Phantom Stock Unit 1 2009-09-10 5 M 0 28777 0 D Common Stock 28777 115101.136 I by Grantor Trust This settlement of phantom stock under the Executive Retirement Matching Contribution Plan is exempt from Section 16(b) under Rule 16b-6(b) and Rule 16b-3. Securities held by Nicholas S. Oliva, Trustee of the Irwin Mark Jacobs' Grantor Retained Annuity Trust. Securities held by Nicholas S. Oliva, Trustee of the Joan Klein Jacobs' Grantor Retained Annuity Trust. Securities held by Irwin M. Jacobs & Joan Klein Jacobs as Trustees of the Irwin Mark Jacobs & Joan Klein Jacobs Family Trust UTA dtd 6/2/80, as amended 6/30/92. The common stock issued under the terms of the Company's Executive Retirement Matching Contribution Plan, a tax conditioned plan, is exempt under Rule 16b-3. The shares are held in a grantor trust and stock is the only permissable form of distribution under the Plan. The rights awarded under the Company's Executive Retirement Matching Contribution Plan will be eligible for distribution upon termination and vest according to the following schedule: 100% at age 65 with acceleration provisions (1) at the rate of 25% per year for each subsequent year of participation, (2) after the individual reaches age 61, or (3) if they have more than 10 years of service. The rights awarded under the Company's Executive Retirement Matching Contribution Plan will be eligible for distribution upon termination. By: Noreen E. Burns, Attorney-in-Fact For: Irwin M. Jacobs 2009-10-05 -----END PRIVACY-ENHANCED MESSAGE-----