-----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, D+MJO7akJP5r584uKnjfvk4sdZbgXe1i6rTPEUiaSpJz0m0eGqMur6frrAfod6Xq pMa2eNjYQleS4A3oWJJ1kQ== 0001209191-04-048562.txt : 20041015 0001209191-04-048562.hdr.sgml : 20041015 20041015161750 ACCESSION NUMBER: 0001209191-04-048562 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040831 FILED AS OF DATE: 20041015 DATE AS OF CHANGE: 20041015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEISZ DENNIS J CENTRAL INDEX KEY: 0001267933 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-10078 FILM NUMBER: 041081297 MAIL ADDRESS: STREET 1: 1495 STEIGER LAKE LANE CITY: VICTORIA STATE: MN ZIP: 85386 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEI INC CENTRAL INDEX KEY: 0000351298 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 410944876 STATE OF INCORPORATION: MN FISCAL YEAR END: 0831 BUSINESS ADDRESS: STREET 1: 1495 STEIGER LAKE LN STREET 2: P O BOX 5000 CITY: VICTORIA STATE: MN ZIP: 55386 BUSINESS PHONE: 9524432500 MAIL ADDRESS: STREET 1: P O BOX 5000 STREET 2: 1495 STEIGER LAKE LANE CITY: VICTORIA STATE: MN ZIP: 55386 5 1 doc5.xml FORM 5 SUBMISSION X0202 5 2004-08-31 0 0 1 0000351298 HEI INC HEII 0001267933 LEISZ DENNIS J PO BOX 5000 1495 STEIGER LAKE LANE VICTORIA MN 55386 1 0 0 0 Stock Option (Right to Buy) 2.16 2003-02-05 4 A 0 L 10000 0.00 A 2013-02-05 Common Stock 10000 10000 D Stock Option (Right to Buy) 1.68 2003-03-19 4 A 0 L 50000 0.00 A 2003-03-19 2013-03-19 Common Stock 50000 60000 D Stock Option (Right to Buy) 2.75 2004-01-14 4 A 0 L 20000 0.00 A 2004-01-14 2014-01-14 Common Stcok 20000 80000 D Stock Option (Right to Buy) 3.40 2004-02-11 4 A 0 L 10000 0.00 A 2014-02-11 Common Stock 10000 90000 D The shares will vest and become exercisable on the earlier of (i) the seventh anniversary of the date of grant, (ii) the first date after the date of grant on which the market value per shares of the common stock of HEI, Inc. equals or exceeds $25.00, (iii) the date of Mr. Leisz's death or disability, or (iv) the effective date of a change of control. The shares vest and become exercisable at 25% upon issuance and 25% on each anniversary date. /s/ Douglas J. Nesbit - Attorney in Fact 2004-10-15 -----END PRIVACY-ENHANCED MESSAGE-----