Orbitz Inc SEC Form 3 Filed December 16, 2003: Initial statement of beneficial ownership of securiti... Last Updated February 7, 2021 at 11:04 PM ST

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PRIMARY DOCUMENT

SEC FORM 3 SEC Form 3
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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OMB Number: 3235-0104
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1. Name and Address of Reporting Person*
GRIFFIN J TIMOTHY

(Last) (First) (Middle)
2700 LONE OAK PARKWAY

(Street)
EAGAN MN 55121

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/16/2003
3. Issuer Name and Ticker or Trading Symbol
ORBITZ INC [ ORBZ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
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)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Incentive Compensation Award (right to buy) (1) 01/15/2004 01/15/2011 See footnote(1) (1) (1) D
Explanation of Responses:
1. Represents right to receive contingent cash payments pursuant to an incentive compensation award f or 10 Points granted to the Reporting Person under the Northwest Airlines Corporation E-Commerce Incentive Compensation Program (the "Program"), the amount of which payments derive, in part, from the value of the Class B-NW Common Stock of Orbitz, Inc. and the Class A LLC Units and the Class B LLC Units of Orbitz LLC. The award vests in four equal annual installments over four years from the date of grant on January 15, 2001, and payments made pursuant to the applicable formula for investments included in the Program, if any, may be made on the tenth anniversary of the grant date or earlier upon certain dispositions of investments.
Remarks:
J. Timothy Griffin 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.
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