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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/29/2005 |
3. Issuer Name and Ticker or Trading Symbol
VISTAPRINT LTD [ VPRT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) 09/29/2005 |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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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 Shares | 1,903,075 | I | See Footnote(1) |
Common Shares | 600,000 | I | See Footnote(2) |
Common Shares | 600,000 | I | See Footnote(3) |
Common Shares | 54,900 | I | See Footnote(4) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 Share Option (Right to Buy) | 01/12/2002(5) | 01/12/2006 | Common Shares | 10,000 | 1.23 | D | |
Incentive Share Option (Right to Buy) | 08/01/2002(5) | 08/01/2006 | Common Shares | 200,000 | 1.23 | D | |
Incentive Share Option (Right to Buy) | 07/01/2003(6) | 07/01/2007 | Common Shares | 40,000 | 1.11 | D | |
Nonqualified Share Option (Right to Buy) | 01/28/2005(6) | 01/28/2014 | Common Shares | 150,000 | 4.11 | D | |
Nonqualified Share Option (Right to Buy) | 05/01/2006(7) | 05/31/2015 | Common Shares | 700,000 | 12.33 | D |
Explanation of Responses: |
1. Shares held by the Robert & Heather Keane Nevis Trust. Mr. Keane disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. |
2. Shares held by the Robert Keane 2003 Irrevocable Trust. Mr. Keane disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. |
3. Shares held by the Heather K.L. McEvoy Keane 2003 Irrevocable Trust. Heather K.L. McEvoy Keane is Mr. Keane's spouse. Mr. Keane disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. |
4. Shares held by the Keane Family Irrevocable Trust, a trust for the benefit of Mr. Keane's minor daughter. Mr. Keane disclaims beneficial ownership of such shares except to the extent of his pecuniary interest therein. |
5. Fully vested. |
6. Options vest over four years, 25% one year after the date of grant and 6.25% per quarter thereafter. |
7. Options vest over four years, 25% on May 1, 2006 and 6.25% per quarter thereafter. |
/s/ Dean J. Breda, Attorney in Fact for Robert S. Keane | 09/29/2005 | |
** 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. |