-----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, I1cDFR2UelOD6lvq5EorU028heRZonYTAZ1M7nC5errzQHsD45bhvE1yY0dTVGv/ i8yc5UdbYT0lE5OFSSuTcA== 0001181431-03-031312.txt : 20031117 0001181431-03-031312.hdr.sgml : 20031117 20031117143252 ACCESSION NUMBER: 0001181431-03-031312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031113 FILED AS OF DATE: 20031117 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHIPPAC INC CENTRAL INDEX KEY: 0001093779 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 770463048 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 47400 KATO ROAD CITY: FREMONT STATE: CA ZIP: 94538 BUSINESS PHONE: 5109798000 MAIL ADDRESS: STREET 1: 47400 KATO ROAD CITY: FREMONT STATE: CA ZIP: 94538 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAIN CAPITAL FUND VI LP CENTRAL INDEX KEY: 0001065042 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-31173 FILM NUMBER: 031007666 BUSINESS ADDRESS: STREET 1: TWO COPLEY PLACE STREET 2: 7TH FL CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 6175723000 MAIL ADDRESS: STREET 1: TWO COPLEY PL STREET 2: 7TH FL CITY: BOSTON STATE: MA ZIP: 02116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAIN CAPITAL PARTNERS VI LP CENTRAL INDEX KEY: 0001260860 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-31173 FILM NUMBER: 031007665 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVENUE CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: 617 516 2000 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVENUE CITY: BOSTON STATE: MA ZIP: MA REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BAIN CAPITAL INVESTORS LLC CENTRAL INDEX KEY: 0001040508 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-31173 FILM NUMBER: 031007667 BUSINESS ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVE CITY: BOSTON STATE: MA ZIP: 02199 BUSINESS PHONE: 6175162000 MAIL ADDRESS: STREET 1: C/O BAIN CAPITAL LLC STREET 2: 111 HUNINGTON AVE CITY: BOSTON STATE: MA ZIP: 02199 4 1 rrd23001.xml BAIN CAPITAL FUND VI, LP11-13-03 X0201 42003-11-130 0001093779 CHIPPAC INC CHPC 0001065042 BAIN CAPITAL FUND VI LP c/o Bain Capital, LLC111 Huntington AvenueBostonMA021990010 0001040508 BAIN CAPITAL INVESTORS LLC c/o Bain Capital, LLC111 Huntington AvenueBostonMA021990010 0001260860 BAIN CAPITAL PARTNERS VI LP C/O BAIN CAPITAL, LLC 111 HUNTINGTON AVENUE BOSTON MA 02199 0010Class A Common Stock2003-11-134J030755910D7845875DClass A Common Stock2003-11-144S0961128.01D7749763DReflects a pro rata distribution of such shares by the Reporting Person to its partners.Bain Capital Fund VI, L.P., by Bain Capital Partners VI, L.P., its general partner, by Bain Capital Investors, LLC, its general partner, by /s/ Michael Goss, a Managing DirectorInvestors, LLC, Its General Partner2003-11-17Bain Capital Partners VI, L.P., by Bain Capital Investors, LLC, by /s/ Michael Goss, a Managing Director2003-11-17Bain Capital Investors, LLC, by /s/ Michael Goss, a Managing Director2003-11-17 -----END PRIVACY-ENHANCED MESSAGE-----