1. Name and Address of Reporting Person * |
Â
CHAN ANNIE M H |
|
2. Date of Event Requiring Statement (Month/Day/Year) 08/21/2001 |
3. Issuer Name and Ticker or Trading Symbol VIALTA INC [VLTA]
|
19770 STEVENS CREEK BLVD. |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director |
__X__ 10% Owner |
_____ Officer (give title below) |
_____ Other (specify below) |
|
|
5. If Amendment, Date Original Filed(Month/Day/Year)
|
CUPERTINO, CA 95014 |
6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
|
Table I - Non-Derivative Securities Beneficially Owned |
|
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) |
Class A Common Stock
|
13,628,050
(1)
|
D
(2)
|
Â
|
Class A Common Stock
|
637,084
(1)
|
I
(3)
|
See Footnote
|
Class A Common Stock
|
962,832
(1)
|
I
(4)
(10)
|
See Footnotes
|
Class A Common Stock
|
962,830
(1)
|
I
(5)
(10)
|
See Footnotes
|
Class A Common Stock
|
330,960
(1)
|
I
(6)
(10)
|
See Footnotes
|
Class A Common Stock
|
2,094,268
(1)
|
I
(7)
(10)
|
See Footnotes
|
Class A Common Stock
|
4,400,000
(1)
|
I
(8)
|
See Footnote
|
Class A Common Stock
|
8,800,000
(1)
|
I
(9)
|
See Footnote
|
|
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 of Derivative Security: 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 |
Non-qualified Stock Option
|
07/03/2001(11)
|
07/03/2006 |
Common Stock
|
401,880
(1)
|
$
0
|
I
|
Spouse - Fred S.L. Chan
|
Non-qualified Stock Option
|
01/03/2003(12)
|
01/03/2011 |
Common Stock
|
295,500
(1)
|
$
0
|
I
|
Spouse - Fred S.L. Chan
|
Incentive Stock Option
|
09/01/2003(13)
|
10/05/2009 |
Common Stock
|
1,000,000
(1)
|
$
0.275
|
I
|
Spouse - Fred S.L. Chan
|
* |
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). |
(1) |
Shares previously reported on Form 3 of Fred S.L. Chan filed July 24, 2001, as amended on August 13, 2002, and/or Form 4 of Fred S.L. Chan filed September 10, 2001, as amended on August 13, 2002. |
(2) |
Shares held by Mrs. Chan, of which 8,042,932 were transferred to Annie M.H. Chan TR UA 07-25-95, the Annie M.H. Chan Living Trust. |
(3) |
Shares held by Mr. Fred S.L. Chan, the spouse of Annie M.H. Chan. Mrs. Chan disclaims beneficial ownership of these securities, except to the extent of any pecuniary interest. |
(4) |
The reported securities were held directly by the David Y.W. Chan Trust UA DTD 12-21-87 (the ?David Chan Trust?). |
(5) |
The reported securities were held directly by the Edward Y.C. Chan Trust UA DTD 12-21-87 (the ?Edward Chan Trust?). |
(6) |
The reported securities were held directly by the Michael Y.J. Chan Trust UA DTD 3-16-92 (the ?Michael Chan Trust?). |
(7) |
The reported securities were held directly by the Shiu Leung Chan & Annie M.H. Chan Gift Trust Dated 11/20/92 (the ?Chan Gift Trust?). |
(8) |
The reported securities were held directly by Fred Chan, the spouse of Mrs. Chan. Mrs. Chan disclaims beneficial ownership of these securities except to the extent of any pecuniary interest. |
(9) |
The reported securities were held directly by Evershine XVI, L.P., of which Mr. and Mrs. Chan are the managing members of the sole general partner. Except to the extent of any indirect pecuniary interest therein, Mrs. Chan disclaims beneficial ownership of these securities. |
(10) |
The David Chan Trust, Edward Chan Trust, Michael Chan Trust and Chan Gift Trust were established by F. Chan and/or A. Chan for the benefit of their children. Mr. and Mrs. Chan are not trustees of these trusts and disclaim beneficial ownership of and any pecuniary interest in these securities. |
(11) |
These options vested over one year in equal monthly installments with the vesting commencement date as noted. |
(12) |
These options vested over four years in equal monthly installments with the vesting commencement date as noted. |
(13) |
These options vested in full one year from the vesting commencement date as noted. |