FORM 3
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Washington, D.C. 20549 |
OMB APPROVAL
OMB Number: 3235-0104 Estimated average burden hours per response... 0.5 |
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1. Name and Address of Reporting Person * JUSTYN TIMOTHY |
2. Date of Event Requiring Statement (MM/DD/YYYY)
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3. Issuer Name and Ticker or Trading Symbol INTEVAC INC [IVAC] |
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___ X ___ Officer (give title below) _____ Other (specify below) EVP & General Manager, / |
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
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) |
Common Stock | 85522 | D |
Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) |
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1. Title of Derivate Security
(Instr. 4) |
2. Date Exercisable and Expiration Date
(MM/DD/YYYY) |
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) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Non-Qualified Stock Option (right to buy) | 2/27/2010 (1) | 2/27/2019 | Common Stock | 10000 | $3.91 | D | |
Non-Qualified Stock Option (right to buy) | 5/9/2014 (1) | 5/9/2020 | Common Stock | 6000 | $4.49 | D | |
Non-Qualified Stock Option (right to buy) | 5/19/2017 (1) | 5/19/2023 | Common Stock | 16250 | $4.8 | D | |
Non-Qualified Stock Option (right to buy) | 5/21/2016 (2) | 5/21/2022 | Common Stock | 16250 | $5.42 | D | |
Non-Qualified Stock Option (right to buy) | 8/6/2014 (2) | 8/6/2018 | Common Stock | 2286 | $6.54 | D | |
Non-Qualified Stock Option (right to buy) | 5/15/2015 (1) | 5/15/2021 | Common Stock | 8000 | $7.09 | D | |
Non-Qualified Stock Option (right to buy) | 6/21/2013 (1) | 6/21/2019 | Common Stock | 5335 | $7.55 | D | |
Non-Qualified Stock Option (right to buy) | 8/21/2009 (1) | 8/21/2018 | Common Stock | 10000 | $11.16 | D | |
Non-Qualified Stock Option (right to buy) | 5/19/2012 (1) | 5/19/2018 | Common Stock | 10000 | $11.33 | D | |
Non-Qualified Stock Option (right to buy) | 5/20/2011 (1) | 5/20/2018 | Common Stock | 10000 | $11.84 | D | |
Non-Qualified Stock Option (right to buy) | 5/18/2018 (1) | 5/18/2024 | Common Stock | 15000 | $12.75 | D |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
JUSTYN TIMOTHY
3560 BASSETT STREET SANTA CLARA, CA 95054 |
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EVP & General Manager, |
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Signatures
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By: Kevin Soulsby For: Tim Justyn | 3/1/2018 | |
** 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 control number. |