Statement of Changes in Beneficial Ownership (4)
November 19 2014 - 4:27PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Sheikh Khurram P
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2. Issuer Name
and
Ticker or Trading Symbol
SILICON IMAGE INC
[
SIMG
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chief Strategy & Tech Officer
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(Last)
(First)
(Middle)
1140 EAST ARQUES AVE.
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/17/2014
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(Street)
SUNNYVALE, CA 94085
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Performance Shares
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$0
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11/17/2014
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A
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50000
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12/31/2015
(1)
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(2)
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Common Stock
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50000
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$0
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200000
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D
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Explanation of Responses:
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(
1)
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The performance-based restricted stock units ("PBRSUs") will vest as follows on the achievement of certain performance goals determined by the CEO in December for the immediately succeeding vesting period: 16,666 of the total number of shares shall vest on 12/31/15, 16,666 of the total number of shares shall vest on 12/31/16, 16,668 of the total number of shares shall vest on 12/31/17. No Shares will vest as to any of the grants listed herein, upon any of the Vesting Dates unless the recipient continues to provide services to the Registrant as of such Vesting Date. Mr. Sheikh will be required to hold any shares of common stock received upon the vesting of any PBRSUs for one year following the applicable vesting date.
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(
2)
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Any PBRSUs not vesting on a Vesting Date due to the Registrant's GAAP EPS for the fiscal year in question not meeting the target for such fiscal year established by the Compensation Committee shall be forfeited.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Sheikh Khurram P
1140 EAST ARQUES AVE.
SUNNYVALE, CA 94085
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Chief Strategy & Tech Officer
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Signatures
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By: /s/ Ganda Gunawan, Attorney in Fact For: Khurram Sheikh
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11/17/2014
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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