-----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, SOgPTl5w3bXJzjUv/fGZ22gRVx/uTxeBoHFWpsLB+W067/IXtuPM1CezJWM5wzc2 3dSGeEwaeuOprvUCQYUJPA== 0000912057-02-034905.txt : 20020909 0000912057-02-034905.hdr.sgml : 20020909 20020909163308 ACCESSION NUMBER: 0000912057-02-034905 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020831 FILED AS OF DATE: 20020909 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: SARDINI ANN CENTRAL INDEX KEY: 0001184084 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O WEIGHT WATCHERS INTERATIONAL STREET 2: 175 CROSSWAYS PARK WEST CITY: WOODBURY STATE: NY ZIP: 11797-2055 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: WEIGHT WATCHERS INTERNATIONAL INC CENTRAL INDEX KEY: 0000105319 IRS NUMBER: 116040273 STATE OF INCORPORATION: VA FISCAL YEAR END: 1230 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-16769 FILM NUMBER: 02759717 BUSINESS ADDRESS: STREET 1: 175 CROSSWAYS PARK WEST CITY: WOODBURY STATE: NY ZIP: 11797 BUSINESS PHONE: 5163901400 MAIL ADDRESS: STREET 1: 175 CROSSWAYS PARK WEST CITY: WOODBURY STATE: NY ZIP: 11797 4 1 a2088628z4.txt FORM 4
- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ----------------------------- / / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number 3235-0287 LONGER SUBJECT TO Expires: December 31, 2001 SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Estimated average burden FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or Hours per response .... 0.5 CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 ----------------------------- INSTRUCTION 1(b). (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Sardini Ann Weight Watchers International, Inc. (WTW) Director 10% Owner ---- ---- - --------------------------------------------------------------------------------------------- X Officer (give Other (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for ---- title ---- (specify Number of Reporting Month/Year below) below c/o Weight Watchers International, Inc. Person, if an entity Vice President, Chief (Voluntary) August 2002 Financial Officer - -------------------------------------------- ------------------------------------------------------------ 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original _X_Form filed by One Reporting Person 175 Crossways Park West (Month/Year) ___Form filed by More than One Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED Woodbury New York 11797 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature Security action action or Disposed of (D) Securities ship of In- (Instr. 3) Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 8) Owned at End Direct Bene- (Month/ of Month (D) or ficial Day/ ------------------------------------------ (Instr. 3 Indirect Owner- Year) (A) or and 4) (I) ship Code V Amount (D) Price (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 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 4(b)(v). POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. (Over) SEC 1474 (3-99)
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ----------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- (Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex- Exercise Date (Instr. 8) quired (A) or Dis- piration Date Price of (Month/ posed of (D) (Month/Day/ Deriv- Day/ (Instr. 3, 4, and 5) Year) ative Year) Security ------------------- Date Expira- Exer- tion cisable Date ---------------------------------------------------------------------- Code V (A) (D) ----------------------------------------------------------------------------------------------------------------------------- Options (right to buy) $36.32 4-29-02 A V 100,000 See 04-29-12 Note 1 - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- 7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature lying Securities of of Deriv- ship of In- (Instr. 3 and 4) Deriv- ative Form direct ative Securi- of De- Bene- Secur- ties rivative ficial ity Bene- Secu- Own- (Instr. ficially rity: ership 5) Owned Direct (Instr. 4) ----------------------- at End (D) or Title Amount or of Month Indi- Number of (Instr. 4) rect (I) Shares (Instr. 4) - ----------------------------------------------------------------------------------------------- Common Stock, 100,000 100,000 D no par value - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- Explanation of Responses: ----------------------------------- ----------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date Federal Criminal Violations. SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Ann Sardini Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, SEE Instruction 6 for procedure. Note 1: Explanation of Responses: 1) Options for 100,000 shares were granted on April 29, 2002 that vest on the following schedule: 20% on April 29, 2003; 20% on April 29, 2004; 20% on April 29, 2005; 20% on April 29, 2006; and 20% on April 29, 2007. (2)
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