FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
CHIPPAC INC [ CHPC ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 08/04/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Class A Common Stock, $0.01 par value | 08/04/2004 | D | 17,973 | D | (1) | 0 | I | See Footnote(2) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option | $2.55 | 08/04/2004 | D | 60,000 | (3) | (4) | Class A Common Stock | 60,000 | (3) | 0 | D | ||||
Employee Stock Option | $2.88 | 08/04/2004 | D | 100,000 | (5) | (6) | Class A Common Stock | 100,000 | (5) | 0 | D | ||||
Employee Stock Option | $3.75 | 08/04/2004 | D | 60,000 | (7) | (8) | Class A Common Stock | 60,000 | (7) | 0 | D | ||||
Employee Stock Option | $1.88 | 08/04/2004 | D | 75,000 | (9) | (10) | Class A Common Stock | 75,000 | (9) | 0 | D | ||||
Employee Stock Option | $6.9 | 08/04/2004 | D | 60,000 | (11) | (12) | Class A Common Stock | 60,000 | (11) | 0 | D |
Explanation of Responses: |
1. Disposed of pursuant to merger agreement between ChipPAC, Inc. and ST Assembly Test Services Ltd, a Singapore public company limited by shares ("STATS"), in exchange for 15,636 ADRs of STATS having a market value of $6.36 per ADR as of August 5, 2004. |
2. These shares were disposed of by the Bernstein-McCall 1998 Trust, the beneficiaries of which are members of the reporting member's immediate family. |
3. This option, which is currently exercisable, was assumed by STATS in the merger and replaced with an option to purchase 52,200 ADRs of STATS for $2.93 per ADR. |
4. Any portion of the option which has not been exercised prior to the termination of the reporting person's employment with STATS or any of its subsidiaries will expire on the earlier of: (i) six months after such termination date if such termination is due to the employee's death or disability, (ii) 30 days after such termination date if the termination is for any reason other than the employee's death or disability and (iii) March 17, 2013. |
5. This option, which is currently exercisable, was assumed by STATS in the merger and replaced with an option to purchase 87,000 ADRs of STATS for $3.31 per ADR. |
6. Any portion of the option which has not been exercised prior to the termination of the reporting person's employment with STATS or any of its subsidiaries will expire on the earlier of: (i) six months after such termination date if such termination is due to the employee's death or disability, (ii) 30 days after such termination date if the termination is for any reason other than the employee's death or disability and (iii) December 19, 2010. |
7. This option, which is currently exercisable, was assumed by STATS in the merger and replaced with an option to purchase 52,200 ADRs of STATS for $4.31 per ADR. |
8. Any portion of the option which has not been exercised prior to the termination of the reporting person's employment with STATS or any of its subsidiaries will expire on the earlier of: (i) six months after such termination date if such termination is due to the employee's death or disability, (ii) 30 days after such termination date if the termination is for any reason other than the employee's death or disability and (iii) March 21, 2011. |
9. This option, which is currently exercisable, was assumed by STATS in the merger and replaced with an option to purchase 65,250 ADRs of STATS for $2.16 per ADR. |
10. Any portion of the option which has not been exercised prior to the termination of the reporting person's employment with STATS or any of its subsidiaries will expire on the earlier of: (i) six months after such termination date if such termination is due to the employee's death or disability, (ii) 90 days after such termination date if the termination is for any reason other than the employee's death or disability and (iii) September 26, 2011. |
11. This option vests on February 4, 2005 and was assumed by STATS in the merger and replaced with an option to purchase 52,200 ADRs of STATS for $7.93 per ADR. |
12. Any portion of the option which has not been exercised prior to the termination of the reporting person's employment with STATS or any of its subsidiaries will expire on the earlier of: (i) six months after such termination date if such termination is due to the employee's death or disability, (ii) 30 days after such termination date if the termination is for any reason other than the employee's death or disability and (iii) February 4, 2014. |
/s/ Eva H. Davis, under power of attorney filed previously. | 08/06/2004 | |
** 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 4 (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. |