0001127602-21-005389.txt : 20210212 0001127602-21-005389.hdr.sgml : 20210212 20210212133923 ACCESSION NUMBER: 0001127602-21-005389 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210102 FILED AS OF DATE: 20210212 DATE AS OF CHANGE: 20210212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chiasson William B CENTRAL INDEX KEY: 0001308725 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19848 FILM NUMBER: 21625316 MAIL ADDRESS: STREET 1: C/O LEAPFROG ENTERPRISES, INC. STREET 2: 6401 HOLLIS STREET, SUITE 150 CITY: EMERYVILLE STATE: CA ZIP: 94608 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fossil Group, 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: 1228 BUSINESS ADDRESS: STREET 1: 901 S CENTRAL EXPRESSWAY CITY: RICHARDSON STATE: TX ZIP: 75080 BUSINESS PHONE: 9722342525 MAIL ADDRESS: STREET 1: 901 S CENTRAL EXPRESSWAY CITY: RICHARDSON STATE: TX ZIP: 75080 FORMER COMPANY: FORMER CONFORMED NAME: FOSSIL INC DATE OF NAME CHANGE: 19940218 5 1 form5.xml PRIMARY DOCUMENT X0306 5 2021-01-02 0 1 0000883569 Fossil Group, Inc. FOSL 0001308725 Chiasson William B 901 S. CENTRAL EXPRESSWAY RICHARDSON TX 75080 1 Common Stock 2018-08-13 5 G 0 19045 0 D 19644 D Common Stock 2018-08-13 4 J 0 L 19045 0 A 41245 I William and Carol Chiasson 99 Family Trust W Chiasson and C Chiasson TTEE Common Stock 2020-02-28 5 G 0 22200 0 D 19644 D Common Stock 2020-02-28 4 J 0 L 22200 0 A 41245 I William and Carol Chiasson 99 Family Trust W Chiasson and C Chiasson TTEE G5 - Mr. Chiasson transferred the shares to a family trust of which he is a trustee and of which members of his immediate family are the sole beneficiaries. The shares held by this trust have been incorrectly reported as directly beneficially owned in Section 16 reports following the date of this gift. Not applicable. Mr. Chiasson transferred the shares to a family trust of which he is a trustee and of which members of his immediate family are the sole beneficiaries. Consists of 6,500 Restricted Stock Units subject to a vesting schedule /s/ Randy S. Hyne, Attorney-in-Fact 2021-02-12