-----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, VzV3/0oteijavjY+CuU3v9Ua63WeUQ9clmJ6rw9Ea3y2t+b8AI4bk3RjsQbBP5t2 RwFWeZG/rCW75UGZ0rMJcw== 0001181431-04-040191.txt : 20040813 0001181431-04-040191.hdr.sgml : 20040813 20040813212010 ACCESSION NUMBER: 0001181431-04-040191 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040804 FILED AS OF DATE: 20040813 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POTTER MICHAEL CENTRAL INDEX KEY: 0001226323 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-31173 FILM NUMBER: 04975989 BUSINESS ADDRESS: STREET 1: 47400 KATO ROAD CITY: FREMONT STATE: CA ZIP: 94538 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 4/A 1 rrd50493.xml AMENDED FORM 4 X0202 4/A 2004-08-04 2004-08-09 1 0001093779 CHIPPAC INC CHPC 0001226323 POTTER MICHAEL C/O CHIPPAC, INC. 47400 KATO ROAD FREMONT CA 94538 0 1 0 0 Chief Financial Officer Employee Stock Option 3.75 2004-08-04 4 D 0 24000 D 2011-03-21 Class A Common Stock 24000 0 D This amendment is to correct (i) the exercise price of the derivative security, (ii) the number of derivative securities disposed of and the amount of underlying shares of Class A Common Stock and, as a result of the foregoing corrections, (iii) the price of the derivative security per ADR, as reported on the Form 4 of Michael Potter dated as of August 6, 2004. The option vests over four years beginning March 22, 2002 and was assumed by ST Assembly Test Services Ltd, a Singapore public company limited by shares ("STATS"), in the merger and replaced with an option to purchase 20,880 ADRs of STATS for $4.31 per ADR. /s/ Eva H. Davis, under power of attorney filed previously 2004-08-13 -----END PRIVACY-ENHANCED MESSAGE-----