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*
DOERR L JOHN

(Last) (First) (Middle)
400 N. MCCARTHY BLVD.

(Street)
MILPITAS CA 95035

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/29/2003
3. Issuer Name and Ticker or Trading Symbol
PALMONE INC [ PLMO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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 19,288(1) D
Common Stock 1,319,985(1) I by Partnership
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
Non-Qualified Stock Option (right to buy)(2) 11/07/2003 11/07/2012 Common Stock 1,012 $11.34 D
Non-Qualified Stock Option (right to buy)(3) 10/29/2004(4) 10/29/2013 Common Stock 28,000 $17.5 D
Non-Qualified Stock Option (right to buy)(2) 10/29/2003 11/14/2011 Common Stock 1,012 $30.34 D
Explanation of Responses:
1. Handspring shares held on 10/28/03 which were converted to palmOne shares; 3,256,452 shares are held by the Strauss-Hawkins Trust and 4,815 shares are held by the Hawkins One Trust and 6,300 shares are held by the Hawkins Two Trust and 6,300 shares are held by the Hawkins Three Trust for a total of 3,273,867 shares held by Trusts.
2. Handspring, Inc. 2000 option plan, which palmOne, Inc. has assumed.
3. 2001 Stock Option Plan for Non-Employee Directors
4. The stock option becomes exercisable 33% a year on the anniversary of the grant date.
By: Judy Bruner, Attorney-in-Fact For: L. John Doerr 10/31/2003
** 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.
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