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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
o | Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. | Name and Address of Reporting Person* |
2. | Issuer Name and Ticker or Trading Symbol |
3. | I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) |
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Belanger, Richard (Last) (First) (Middle) |
Forrester Research, Inc. (FORR) |
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c/o Forrester Research 400 Technology Square (Street) |
4. | Statement for Month/Day/Year | 5. | If Amendment, Date of Original (Month/Day/Year) | ||||||||
3/31/2003 |
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6. | Relationship of Reporting Person(s) to Issuer (Check All Applicable) |
7. | Individual or Joint/Group Filing (Check Applicable Line) |
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Cambridge, MA 02139 (City) (State) (Zip) |
o | Director | o | 10% Owner | x | Form Filed by One Reporting Person | ||||||
x | Officer (give title below) | o | Form Filed by More than One Reporting Person | |||||||||
o | Other (specify below) | |||||||||||
Chief Technology Officer |
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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). |
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||||||||||
1. | Title of Security (Instr. 3) |
2. | Transaction Date (Month/Day/Year) |
2A. | Deemed Execution Date, if any (Month/Day/Year) |
3. | Transaction Code (Instr. 8) |
4. | Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
5. | Amount of Sec- urities Beneficially Owned Following Reported Trans- action(s) (Instr. 3 and 4) |
6. | Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
7. | Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | Amount | (A) or (D) |
Price | |||||||||||||||||||
Page 2
Table II Derivative
Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
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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) |
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Code | V | (A) | (D) | ||||||||||||||
Incentive Stock Option (right to buy) | $ | 14.7300 | 03/31/03 | A | 5,943 | ||||||||||||
Non-Qualified Stock Option (right to buy) | $ | 14.7300 | 03/31/03 | A | 9,057 | ||||||||||||
Page 3
Table II Derivative
Securities Acquired, Disposed of, or Beneficially Owned Continued (e.g., puts, calls, warrants, options, convertible securities) |
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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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Date Exercisable |
Expiration Date |
Title | Amount or Number of Shares |
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(1) | 03/30/13 | Common Stock | 5,943 | 5,943 | D | ||||||||||||
(1) | 03/30/13 | Common Stock | 9,057 | 9,057 | D | ||||||||||||
Explanation of Responses:
(1) The Options become exercisable in four equal installments on the first, second, third, and fourth anniversaries of the grant date.
/s/ Kimberly Maxwell | 4/1/03 | |
**Signature of Reporting Person |
Date |
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By: Kimberly Maxwell For: Richard Belanger |
** | 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. |
Page 4
I hereby constitute and appoint each of Timothy J. Moynihan, Brittany E. Roberts, and Kimberly Maxwell, signing singly, my true and lawful attorney-in-fact to:
(1) | execute for and on my behalf, in my capacity as an officer and/or director of Forrester Research, Inc. (the Company), Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; | ||
(2) | do and perform any and all acts for and on my behalf that may be necessary or desirable to complete and execute any such Form 3, 4 or 5 and timely file such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and | ||
(3) | take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be to my benefit, in my best interest, or that I am legally required to do, it being understood that the documents executed by such attorney-in-fact on my behalf pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-facts discretion. |
I hereby grant to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-facts substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. I acknowledge that the attorneys-in-fact, in serving in such capacity at my request, are not assuming, nor is the Company assuming, any of my responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until I am no longer required to file Forms 3, 4 and 5 with respect to my holdings of and transactions in Company securities, unless I earlier revoke it in a signed writing delivered to the attorneys-in-fact.
IN WITNESS WHEREOF, I have caused this Power of Attorney to be executed as of this 19th day of November, 2002.
/s/ Richard C. Belanger |
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Signature | ||
Richard C. Belanger |
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Print Name |