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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
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) |
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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option (Right to Buy) | $ 20.595 (1) | 08/22/2005 | M | 9,000 (2) | (3) | 01/24/2012 | Common Stock | 9,000 (2) | $ 0 | 0 | D | ||||
Employee Stock Option (Right to Buy) | $ 12.7225 (4) | 08/22/2005 | M | 9,000 (5) | (6) | 07/29/2012 | Common Stock | 9,000 (5) | $ 0 | 0 | D | ||||
Employee Stock Option (Right to Buy) | $ 9.675 (7) | 08/22/2005 | M | 5,666 (8) | (9) | 02/03/2013 | Common Stock | 11,334 (8) | $ 0 | 5,668 | D | ||||
Employee Stock Option (Right to Buy) | $ 13.67 | 08/22/2005 | M | 11,332 (10) | (11) | 08/03/2013 | Common Stock | 17,000 (10) | $ 0 | 5,668 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KOEHLER MICHAEL 1700 S. PATTERSON BOULEVARD DAYTON, OH 45479 |
Senior Vice President |
Nelson F. Greene, Attorney-in-fact for Michael Koehler | 08/24/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Previously reported price was $41.19. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the previously reported price of $41.19 split to $20.595. |
(2) | Previously reported number of securities was 4,500. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the previously reported number of securities of 4,500 increased to 9,000. |
(3) | The option vested in 3 equal annual installments beginning on 01/24/2003. |
(4) | Previously reported price was $25.45. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the previously reported price of $25.45 split to $12.7225. |
(5) | Previously reported number of securities was 4,500. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the previously reported number of securities of 4,500 increased to 9,000. |
(6) | The option vested in 3 equal annual installments beginning on 07/29/2003. |
(7) | Previously reported price was $19.35. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the previously reported price of $19.35 split to $9.675. |
(8) | Previously reported number of securities was 8,500. On November 15, 2004, 2,833 of these securities were exercised, leaving 5,667 unexercised. On January 21, 2005, the common stock of NCR Corporation split 2-for-1, with the result that the 5,667 unexercised options increased to 11,334, 5,666 of which are being exercised at this time. |
(9) | The option vests in 3 equal annual installments beginning on 02/03/2004. |
(10) | Previously reported number of securities was 8,500. On January 21, 2005, the common sock of NCR Corporation split 2-for-1, with the result that the previously reported number of securities of 8,500 increased to 17,000, of which 11,332 are being exercised at this time. |
(11) | The option vests in 3 equal annual installments beginning on August 4, 2004. |