-----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, WY/vr1JoaL26fdDGtTiyBZuKBdOA4ap0ZCQOAD6LC08u1ViXblmJJroijDcYtsMz pRF0z6mJSJvjo/8M4G8QZA== 0001183976-03-000183.txt : 20030925 0001183976-03-000183.hdr.sgml : 20030925 20030925174938 ACCESSION NUMBER: 0001183976-03-000183 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030924 FILED AS OF DATE: 20030925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHROFF JAL S CENTRAL INDEX KEY: 0001183973 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19848 FILM NUMBER: 03910852 MAIL ADDRESS: STREET 1: 2280 NORTH GREENVILLE AVENUE CITY: RICHARDSON STATE: TX ZIP: 75082 ISSUER: 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 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 4 1 c0001183973d20030925f4f.xml PRIMARY DOCUMENT X0201 42003-09-2400000883569FOSSIL INC FOSL0001183973SHROFF JAL S2280 N. GREENVILLERICHARDSONTX750821100Managing Director, Fossil EastCommon Stock2003-09-244S01000026.25D626491DCommon Stock2003-09-254S03000026.23D596491DStock Options (Right to buy)1.9631997-01-102006-01-10Common Stock2531225312DStock Options (Right to buy)3.70381998-02-062007-02-06Common Stock2531225312DStock Options (Right to buy)3.87041996-01-032005-01-03Common Stock2531225312DStock Options (Right to buy)6.51999-01-122008-01-12Common Stock1771917719DStock Options (Right to buy)10.66672001-02-022010-02-02Common Stock75007500DStock Options (Right to buy)11.3752002-01-222011-01-22Common Stock1125011250DStock Options (Right to buy)12.02782000-02-122009-02-12Common Stock1125011250DStock Options (Right to buy)13.83342003-01-142012-01-14Common Stock1125011250DStock Options (Right to buy)1.9631997-01-102006-01-10Common Stock2531225312IPervin ShroffSto ck Options (Right to buy)3.70381998-02-062007-02-06Common Stock2531225312IPervin ShroffStock Options (Right to buy)3.87041996-01-032005-01-03< /expirationDate>Common Stock2531225312IPervin ShroffStock Options (Right to buy)6.51999-01-122008-01-12Common Stock1771917719IPervin ShroffStock Options (Right to buy)10.66672001-02-022010-02-02Common Stock1500015000IPervin ShroffStock Options (Right to buy)11.3752002-01-222011-01-22Common Stock1125011250IPervin ShroffStock Options (Right to buy)1 2.02782000-02-122009-02-12Common Stock1125011250IPervin ShroffStock Options (Right to buy)13.83342003-01-142012-01-14Common Stock1124911249IPervin ShroffAmount reported as beneficially owned in Column 5 of 626,491 reflects direct ownership following disposition of 10,000 shares reported in Column 4. Actual amount of securities beneficially owned following disposition on September 25, 2003 is 596,491 shares.JAL SHROFF2003-09-25 -----END PRIVACY-ENHANCED MESSAGE-----