- Statement of Changes in Beneficial Ownership (4)
11 10월 2008 - 8:17AM
Edgar (US Regulatory)
FORM 4
[
X
]
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
Expires:
February 28, 2011
Estimated average burden
hours per response...
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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(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Buyer Lise J
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2. Issuer Name
and
Ticker or Trading Symbol
GREENFIELD ONLINE INC
[
SRVY
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
CLASS V GROUP, 3130 ALPINE ROAD, SUITE 288-414
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3. Date of Earliest Transaction
(MM/DD/YYYY)
10/8/2008
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(Street)
PORTOLA VALLEY, CA 94028
(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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Options (Right to Buy)
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$13.00
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10/8/2008
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D
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40000
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(1)
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7/15/2014
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Common Stock
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40000
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(1)
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0
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D
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Options (Right to Buy)
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$7.27
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10/8/2008
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D
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2500
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(1)
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5/16/2016
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Common Stock
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2500
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(1)
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0
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D
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Options (Right to Buy)
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$15.54
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10/8/2008
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D
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5250
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(1)
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6/8/2014
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Common Stock
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5250
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(1)
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0
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D
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Explanation of Responses:
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(
1)
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This option, was canceled and terminated (whether or not then vested and exercisable) as of October 8, 2008 pursuant to that certain Agreement and Plan of Merger (the "Merger Agreement"), dated as of August 29, 2008, by and among the issuer, Crisp Acquisition Corporation and Microsoft Corporation in exchange for a cash payment for each option share in an amount equal to the excess of the Merger Consideration (defined in the Merger Agreement as $17.50 per share, net to the seller in cash, without interest) and the per share exercise price.
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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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Buyer Lise J
CLASS V GROUP, 3130 ALPINE ROAD
SUITE 288-414
PORTOLA VALLEY, CA 94028
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X
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Signatures
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Gary J. Kocher, Attorney-in-fact
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10/10/2008
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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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