-----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, EZ048gxlp4GP7TgVzY+6c46zEOFgS+6eXRnr7acGgvFNoF/wLYB/22AajgwQbuVi 2H7IaCOYUnHHKNh6bmaNjA== 0000892569-02-002501.txt : 20021210 0000892569-02-002501.hdr.sgml : 20021210 20021209191147 ACCESSION NUMBER: 0000892569-02-002501 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021209 FILED AS OF DATE: 20021210 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: WOMACK CARL CENTRAL INDEX KEY: 0001194949 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: 3450 EAST MIRAOMA AVE CITY: ANAHEIM STATE: CA ZIP: 92806 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PACIFIC SUNWEAR OF CALIFORNIA INC CENTRAL INDEX KEY: 0000874841 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-APPAREL & ACCESSORY STORES [5600] IRS NUMBER: 953759463 STATE OF INCORPORATION: CA FISCAL YEAR END: 0131 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21296 FILM NUMBER: 02852839 BUSINESS ADDRESS: STREET 1: 3450 EAST MIRALOMA AVENUE CITY: ANAHEIM STATE: CA ZIP: 92806 BUSINESS PHONE: 714-414-4000 MAIL ADDRESS: STREET 1: 3450 EAST MIRALOMA AVENUE CITY: ANAHEIM STATE: CA ZIP: 92806 4 1 a86427e4.htm FORM 4 Pacific Sunwear of California Inc.
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 4

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935
or Section 30(h) of the Investment Company Act of 1940

o 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*
2. Issuer Name and Ticker or Trading
Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Womack, Carl
(Last) (First) (Middle)
  Pacific Sunwear of California Inc. (PSUN)
 
     
  3450 East Miraloma Ave

(Street)
4. Statement for Month/Day/Year 5. If Amendment, Date of Original (Month/Day/Year)
    12/09/2002
 
     
    6. Relationship of Reporting Person(s)
to Issuer
(Check All Applicable)
7. Individual or Joint/Group Filing
(Check Applicable Line)
  Anaheim, CA 92806-2101
(City)        (State)        (Zip)
  o  Director o  10% Owner   x Form Filed by One Reporting Person
    x  Officer (give title below)   o Form Filed by More than One Reporting Person
    o  Other (specify below)  
      Officer CFO
     

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).


 

                                               

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

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 Sec-
urities Beneficially
Owned Following
Reported Trans-
action(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          

  Common Stock   12/6/02     J     600 (1)   D   $27.7100     58,066     D   Direct

                         

                         

                         

                         

                         

                         

                         

                         

                         

Page 2


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
  (e.g., puts, calls, warrants, options, convertible securities)

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)

                      Code V   (A) (D)

  Incentive Stock Option (right to buy)     $14.8333          

  Incentive Stock Option (right to buy)     $15.0420          

  Incentive Stock Option (right to buy)     $16.9800          

  Incentive Stock Option (right to buy)     $21.3500          

  Incentive Stock Option (right to buy)     $23.8130          

  Incentive Stock Option (right to buy)     $25.8130          

  Non-Qualified Stock Option (right to buy)     $6.1852          

  Non-Qualified Stock Option (right to buy)     $11.7222          

  Non-Qualified Stock Option (right to buy)     $14.8333          

  Non-Qualified Stock Option (right to buy)     $15.0420          

  Non-Qualified Stock Option (right to buy)     $16.9800          

  Non-Qualified Stock Option (right to buy)     $21.3500          

  Non-Qualified Stock Option (right to buy)     $23.8130          

  Non-Qualified Stock Option (right to buy)     $25.8130          

Page 3


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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 of
Derivative Security:
Direct (D) or
Indirect (I)

(Instr. 4)
11. Nature of
Indirect
Beneficial
Ownership

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

  09/08/08   Common Stock 26,552           26,552     D Direct

  01/20/09   Common Stock 641           641     D Direct

  08/07/11   Common Stock 5,256           5,256     D Direct

  02/04/12   Common Stock 1,042           1,042     D Direct

  09/17/09   Common Stock 4,050           4,050     D Direct

  01/03/11   Common Stock 4,291           4,291     D Direct

  12/17/06   Common Stock 1,406           1,406     D Direct

  10/27/07   Common Stock 50,625           50,625     D Direct

  09/08/08   Common Stock 7,199           7,199     D Direct

  01/20/09   Common Stock 10,610           10,610     D Direct

  08/07/11   Common Stock 29,744           29,744     D Direct

  02/04/12   Common Stock 23,958           23,958     D Direct

  09/17/09   Common Stock 45,950           45,950     D Direct

  01/03/11   Common Stock 15,709           15,709     D Direct

Explanation of Responses:

(1) Charitable donation

- With regard to the above listed Derivative Securities, options covering 25% of the shares granted become exercisable 1 year after the date granted. The remaining 75% of the shares granted become exercisable on a monthly basis over the following 3 years.

/s/ Womack, Carl   12/09/02

**Signature of Reporting Person
 
Date


**   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.

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