-----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, MhwppwKFvFgLelmOyG+ITtJtSzbBJZ1nuG5j9nBJlO0GCrv1eunM1UV6t7e5Ms55 jYgYgpt3JM66KwGDd9spww== 0000899078-03-000078.txt : 20030127 0000899078-03-000078.hdr.sgml : 20030127 20030127172032 ACCESSION NUMBER: 0000899078-03-000078 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20030127 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FOSSIL INC CENTRAL INDEX KEY: 0000883569 STANDARD INDUSTRIAL CLASSIFICATION: WATCHES, CLOCKS, CLOCKWORK OPERATED DEVICES/PARTS [3873] IRS NUMBER: 752018505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-43117 FILM NUMBER: 03526455 BUSINESS ADDRESS: STREET 1: 2280 NORTH GREENVILLE AVE CITY: RICHARDSON STATE: TX ZIP: 75082 BUSINESS PHONE: 9722342525 MAIL ADDRESS: STREET 1: 2280 N GREENVILLE CITY: RICHARDSON STATE: TX ZIP: 75082 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KARTSOTIS TOM CENTRAL INDEX KEY: 0000936617 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 2713 WOODS LANE CITY: DALLAS STATE: TX ZIP: 75044 MAIL ADDRESS: STREET 1: 2713 WOODS LANE CITY: DALLAS STATE: TX ZIP: 75044 SC 13G/A 1 amend10to13g.txt United States Securities and Exchange Commission Washington D.C. 20549 Schedule 13G Under the Securities Exchange Act of 1934 (Amendment No. 10) FOSSIL, INC. (Name of Issuer) Common Stock, Par Value $.01 (Title of Class of Securities) 349882100 (CUSIP Number) December 31, 2002 (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section but shall be subject to all other provisions of the Act (however, see the Notes). - -------------------------------------------------------------------------------- 1 Names of Reporting Persons I.R.S. Identification Nos. of Above Person (entities only) Tom Kartsotis - -------------------------------------------------------------------------------- 2 Check the Appropriate Box if a Member of A Group (See Instructions) (a) [ ] (b) [ ] - -------------------------------------------------------------------------------- 3 SEC Use Only - -------------------------------------------------------------------------------- 4 Citizenship or Place of Organization United States of America - -------------------------------------------------------------------------------- Number of 5 Sole Voting Power 11,895,696(1) Shares -------------------------------------------- 6 Shared Voting Power Beneficially 0 -------------------------------------------- Owned by 7 Sole Dispositive Power 11,895,696(1) Each Reporting -------------------------------------------- 8 Shared Dispositive Power Person With 0 - -------------------------------------------------------------------------------- 9 Aggregate Amount Beneficially Owned by Each Reporting Person 11,895,696(1) - -------------------------------------------------------------------------------- 10 Check if the Aggregate Amount in Row (9) Excludes Certain Shares* [X] - -------------------------------------------------------------------------------- 11 Percent of Class Represented by Amount in Row (9) 25.7%(2) - -------------------------------------------------------------------------------- 12 Type of Reporting Person* IN - -------------------------------------------------------------------------------- * SEE INSTRUCTIONS BEFORE FILLING OUT! Item 1(a) Name of Issuer: Fossil, Inc. Item 1(b) Address of Issuer's Principal Executive Offices: 2280 N. Greenville Avenue Richardson, Texas 75082 Item 2(a) Name of Person Filing: Tom Kartsotis Item 2(b) Address of Principal Business Office or, if none, Residence: 2280 N. Greenville Avenue Richardson, Texas 75082 Item 2(c) Citizenship: United States of America Item 2(d) Title of Class of Securities: Common Stock, par value $.01 Item 2(e) CUSIP No.: 349882100 Item 3 Not Applicable Item 4 Ownership. (a) Amount Beneficially Owned: 13,704,070(3) (b) Percent of Class: 29.6%(2) (c) Number of Shares as to Which the Person Has: (i) sole power to vote or to direct the vote: 13,704,070 (3) (ii) shared power to vote or to direct the vote: 0 (iii) sole power to dispose or to direct the disposition of: 13,704,070 (3) (iv) shared power to dispose or to direct the disposition of: 0 Item 5 Ownership of Five Percent or less of a Class. Not Applicable (1) Includes 1,000,000 shares that were contributed to a grantor retained annuity trust during the period. (2) Based on 46,372,619 shares issued and outstanding as of December 31, 2002. (3) Includes 1,786,387 shares owned by Lynne Kartsotis, wife of Tom Kartsotis, as to which Mr. Kartsotis disclaims beneficial ownership, and 21,987 shares owned by Mr. Kartsotis as custodian for Annie Grace Kartsotis, a minor. Item 6 Ownership of More than Five Percent on Behalf of Another Person. Not Applicable Item 7 Identification and Classification of the Subsidiary Which Acquired the Security Reported on by the Parent Holding Company. Not Applicable Item 8 Identification and Classification of Members of the Group. Not Applicable Item 9 Notice of Dissolution of Group. Not Applicable Item 10 Certification. Not Applicable Signature After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date: January 16, 2003. Signature: /s/ Tom Kartsotis ------------------------------------------ -----END PRIVACY-ENHANCED MESSAGE-----