-----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, IipPm1WiNJryzCrZcAyKH0iK+DbS9ve3qqqQnjxTcjobJE9v8qYVaA+8YHpbmjDy 3c+C/DaJFH6/IxoYzrE5Lg== 0001181431-03-028186.txt : 20031030 0001181431-03-028186.hdr.sgml : 20031030 20031030174850 ACCESSION NUMBER: 0001181431-03-028186 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031028 FILED AS OF DATE: 20031030 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PALMSOURCE INC CENTRAL INDEX KEY: 0001178056 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 770586278 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5470 GREAT AMERICA PKWY CITY: SANTA CLARA STATE: CA ZIP: 95052 BUSINESS PHONE: 408-878-4000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PALMONE INC CENTRAL INDEX KEY: 0001100389 STANDARD INDUSTRIAL CLASSIFICATION: COMPUTER TERMINALS [3575] STATE OF INCORPORATION: DE FISCAL YEAR END: 0531 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50402 FILM NUMBER: 03967691 BUSINESS ADDRESS: STREET 1: 400 N. MCCARTHY BOULEVARD CITY: MILPITAS STATE: CA ZIP: 95035 BUSINESS PHONE: 4088789000 MAIL ADDRESS: STREET 1: 400 N. MCCARTHY BOULEVARD STREET 2: M/S 4101 CITY: MILPITAS STATE: CA ZIP: 95035-5112 FORMER NAME: FORMER CONFORMED NAME: PALM INC DATE OF NAME CHANGE: 19991203 4 1 rrd21181.xml FORM 4 X0201 42003-10-281 0001178056 PALMSOURCE INC PSRC 0001100389 PALMONE INC 400 N. MCCARTHY BLVD MILPITAS CA 95035 0010Common Stock2003-10-284C010000000A0DCommon Stock2003-10-284J010000000D0DClass C Common Stock2003-10-284C010000000DCommon Stock100000000DThere was no price paid for the conversion of the security. The conversion occurred as a result of a recapitalization of PalmSource.The shares of common stock acquired upon the recapitalization were distributed pro rata to Palm, Inc.'s stockholders on 10/28/2003.There was no conversion, exercise price or price of the Class C Common Stock.There was no date exercisable or expiration date of the Class C Common Stock./s/ Judy Bruner2003-10-28 -----END PRIVACY-ENHANCED MESSAGE-----