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