FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 12/16/2003 |
3. Issuer Name and Ticker or Trading Symbol
ORBITZ INC [ ORBZ ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B- CO Common Stock | (1) | (2) | Class A Common Stock | 942 | (3) | D | |
Class A LLC Units (5) | (1) | (2) | See footnote (4) | 4,948,572 | (3) | D | |
Class B LLC Units (5) | (1) | (2) | See footnote (4) | 84 | (3) | D | |
PARs (short-call option) (6) | (7) | 03/27/2010 | See footnote (8) | 371,368 | 3 | D | |
PARs (short-call option) (6) | (7) | 05/01/2010 | See footnote (9) | 57 | 3 | D | |
PARs (short-call option) (6) | (7) | 10/04/2010 | See footnote (8) | 217,805 | 6.96 | D | |
PARs (short-call option) (6) | (7) | 04/02/2011 | See footnote (8) | 212,032 | 6.96 | D | |
PARs (short-call option) (6) | (7) | 08/10/2011 | See footnote (8) | 339,839 | 6.96 | D | |
PARs (short-call option) (6) | (7) | 08/08/2012 | See footnote (8) | 25,109 | 13.02 | D |
Explanation of Responses: |
1. Immediate |
2. None |
3. 1 for 1 |
4. May be converted into Class A Common Stock, Series B- CO Common Stock and/or Series A Non-Voting Convertible Preferred Stock |
5. Represents membership interests in Orbitz, LLC, an affiliate of the Issuer |
6. Cash settled call option based on the value of the underlying Orbitz security issued to employees of Continental pursuant to the Continental Airlines, Inc. Incentive Plan 2000, Officer Retention and Incentive Award Program (the "Program") |
7. The PARs will be subject to redemption for cash by Continental upon the occurence of a disposition of the underlying securities or, in the case of a liquidity event, as determined under the Program |
8. Represents the right of the employee holding the PAR to receive on redemption from the Reporting Person a cash payment equal to the appreciation in the value of the underlying Class A and Class B LLC Units (which are convertible into Class A Common Stock, Series B-CO Common stock and/or Series A Non-Voting Convertible Preferred Stock on a 1 for 1 basis) over the exercise price of the derivative security. |
9. Represents the right of the employee holding the PAR to receive on redemption from the Reporting Person a cash payment equal to the appreciation in the value of the underlying Series B-CO Common Stock (which is convertible into Class A Common Stock on a 1 for 1 basis) over the exercise price of the derivative security. |
Remarks: |
Jennifer Vogel, Senior Vice President, General Counsel and Secretary | 12/16/2003 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |