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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 | ||||||||
Class B Common Stock | (6) | 11/30/2012 | G(7)(8) | V | 13,914,308 | (6) | (6) | Class A Common Stock | 13,914,308 | (6) | 29,998,272 | I | I (7) (8) | ||
Class B Common Stock | (6) | 11/30/2012 | G(7)(8) | V | 8,273,018 | (6) | (6) | Class A Common Stock | 8,273,018 | (6) | 198,550,495 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ERGEN CHARLES W 9601 S. MERIDIAN BLVD. ENGLEWOOD, CO 80112 |
X | X | Chairman | |
ERGEN CANTEY 9601 S. MERIDIAN BLVD. ENGLEWOOD, CO 80112 |
X | X |
Charles W. Ergen, by Brandon Ehrhart, his Attorney in Fact | 12/04/2012 | |
**Signature of Reporting Person | Date | |
Cantey M. Ergen, by Brandon Ehrhart, her Attorney in Fact | 12/04/2012 | |
**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) | The shares are held by a custodian for the reporting person's children. The reporting person disclaims beneficial ownership of the shares, except to the extent of their pecuniary interest therein. |
(2) | Held by Ms. Cantey M. Ergen. |
(3) | Held by Mr. Charles W. Ergen in a 401(k) account. |
(4) | Held by Ms. Cantey M. Ergen in a 401(k) account. |
(5) | The shares are held by a charitable foundation. The reporting person is an officer of the charitable foundation and has both investment control and voting power for the foundation. The reporting person disclaims beneficial ownership of the shares, except to the extent of their pecuniary interest therein. |
(6) | The holder of the shares of Class B stock may elect to convert any or all of their Class B shares into an equal number of Class A shares at any time for no additional consideration. |
(7) | Pursuant to the terms of the Ergen Two-Year 2010 DISH GRAT, 3,539,893 shares were distributed as an annuity to Mr. Ergen on November 30, 2012, with the remaining 5,641,290 shares distributed to trusts for the reporting persons' family members. Trusts for the reporting persons' family members hold 9,886,441 shares following this distribution. Following these distributions, the Ergen Two-Year DISH GRAT expired pursuant to its terms. |
(8) | Pursuant to the terms of the Ergen Three-Year 2010 DISH GRAT, 2,163,870 shares were distributed as an annuity to Mr. Ergen on November 30, 2012, with the Ergen Three-Year 2010 DISH GRAT retaining 8,697,522 shares. The Ergen Three-Year 2010 DISH GRAT expires on November 30, 2013. Pursuant to the terms of the Ergen Four-Year 2010 DISH GRAT, 1,484,819 shares were distributed as an annuity to Mr. Ergen on November 30, 2012, with the Ergen Four-Year 2010 DISH GRAT retaining 10,205,737 shares. The Ergen Four-Year 2010 DISH GRAT expires on November 30, 2014. Pursuant to the terms of the Ergen Five-Year 2010 DISH GRAT, 1,084,436 shares were distributed as an annuity to Mr. Ergen on November 30, 2012, with the Ergen Five-Year 2010 DISH GRAT retaining 11,095,013 shares. The Ergen Five-Year 2010 DISH GRAT expires on November 30, 2015. |