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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction 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 (Month/Day/Year) |
7. Title and Amount of Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MICHELSON MICHAEL W 2800 SAND HILL ROAD SUITE 200 MENLO PARK, CA 94025 |
X |
/s/ William J. Janetschek, Attorney-in-Fact for Reporting Person | 10/29/2004 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | On October 27, 2004, 183,623 shares of Class A Common Stock of Amphenol Corporation were sold by KKR-NXS L.L.C., which is the sole general partner of KKR Associates (NXS) L.P., which is the sole general partner of NXS Associates L.P. in a secondary offering. As a member of KKR-NXS L.L.C., the Reporting Person may be deemed, for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, to be a "beneficial owner" of shares of Class A Common Stock of NXS Associates L.P.; however, pursuant to Rule 16a-1(a)(2) promulgated under the Act, the Reporting Person disclaims that it is a beneficial owner of such shares of Class A Common Stock. |
(2) | Upon the consummation of the sale, KKR-NXS L.L.C. owned 333,205 shares of common stock, and distributed such shares of common stock to KKR executives and entities. In addition, KKR 1996 GP L.L.C., which is the sole general partner of KKR Associates 1996 L.P., which is the sole general partner of KKR 1996 Fund L.P., distributed all of its 1,527,614 shares of Class A Common Stock to KKR executives and entities. As a result of such transactions, Mr. Michelson owns directly 160,401 shares of Class A Common Stock. |