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FORM 4
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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
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OMB APPROVAL
OMB Number: 3235-0287 Expires: February 28, 2011 Estimated average burden hours per response... 0.5 |
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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
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Elevation Partners, L.P. |
2. Issuer Name
and
Ticker or Trading Symbol
PALM INC [ PALM ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__ X __ Director __ X __ 10% Owner _____ Officer (give title below) _____ Other (specify below) |
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2800 SAND HILL ROAD, SUITE 160 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
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MENLO PARK, CA 94025 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person _ X _ 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) |
2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
| Code | V | Amount | (A) or (D) | Price | ||||||
| Common Stock (1) (2) (4) | 9/22/2009 | P (5) | 2153200 | A | $16.25 | 10316700 | D (6) | |||
| Common Stock (1) (3) (4) | 9/22/2009 | P (5) | 646 | A | $16.25 | 3812 | I | See footnote (7) | ||
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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) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any |
4. Trans. 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 |
7. Title and Amount of Securities Underlying Derivative Security
(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) | ||||
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
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Reporting Owners
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| Reporting Owner Name / Address |
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| Director | 10% Owner | Officer | Other | ||
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Elevation Partners, L.P.
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
X | X |
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Elevation Associates, L.P.
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Elevation Associates, LLC
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Elevation Employee Side Fund, LLC
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Elevation Management, LLC
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Bodnick Marc
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Hewson Paul
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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PEARLMAN BRET D
2800 SAND HILL ROAD SUITE 160 MENLO PARK, CA 94025 |
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X |
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Signatures
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| /*/ Tracy Hogan, Attorney-in-Fact | 9/23/2009 | |
| ** Signature of Reporting Person |
Date
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| 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 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). |
| 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. | |
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Designated Filer:
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Elevation Partners, L.P. | |
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Other Joint Filers:
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Elevation Associates, L.P., Elevation Associates, LLC, Elevation Employee Side Fund, LLC, Elevation Management, LLC, Marc Bodnick, Paul Hewson, and Bret Pearlman | |
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Addresses:
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The principal business address of each of the joint filers listed above is 2800 Sand Hill Road, Suite 160, Menlo Park, CA 94025. | |
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Date of Event Requiring
Statement:
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September 22, 2009 | |
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Issuer Name and Ticker
or Trading Symbol:
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Palm, Inc. [PALM] | |
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Signatures:
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ELEVATION ASSOCIATES, L.P.
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| By: | Elevation Associates, LLC, | |||
| as General Partner | ||||
| By: | /s/ Fred Anderson | |||
| Name: | Fred Anderson | |||
| Title: | Manager | |||
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ELEVATION ASSOCIATES, LLC
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| By: | /s/ Fred Anderson | |||
| Name: | Fred Anderson | |||
| Title: | Manager | |||