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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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* (Last, First, Middle) |
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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Welles, Michael H.
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FORRESTER RESEARCH, INC. (FORR)
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c/o Forrester Research, Inc.
400 Technology Square |
4. | Statement for (Month/Day/Year) | 5. | If Amendment, Date of Original (Month/Day/Year) | ||||||||
November 20, 2002
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(Street) | 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) |
x | Director | o | 10% Owner | x | Form filed by One Reporting Person | ||||||
o | Officer (give title below) | o | Form filed by More than One Reporting Person | |||||||||
o | Other (specify below) | |||||||||||
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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 Securities Beneficially Owned Following Reported Transactions(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 | ||||||||||||||||||||
Common Stock | 11/20/2002 | M | 4,000 | A | 6.500 | D | ||||||||||||||||||
Common Stock | 11/20/2002 | S | 4,000 | D | 15.0930 | 2,016 | D | |||||||||||||||||
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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) | |||||||||||||||
Non Qualified Stock Option (right ot buy) | 6.500 | 11/20/2002 | M | 4,000 | ||||||||||||||
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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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9/25/06 | Common Stock | 4,000 | 8,000 | D | |||||||||||||
Explanation of Responses:
/S/ KIM MAXWELL * | 11/22/2002 | |
**Signature of Reporting Person |
Date |
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* | By Power of Attorney as authorized by Exhibit 99.1 attached hereto | |
** | 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. | |
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POWER OF ATTORNEY 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 may 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-fact's 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 the confirming all that such attorney-in-fact, or such attorney-in-fact's 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 may request, are not assuming, nor is the Company assuming, any of may 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 22nd day of October 2002. /s/ Michael Welles -------------------------------- Signature Micheal Welles -------------------------------- Print Name - --------------------------- * DRAFTER'S NOTE: In filing a Section 16(a) report on behalf of a reporting person, an attorney-in-fact should indicate after the signature line on the form that he or she is signing as such. The Power of Attorney should be attached to and filed with the report, if it has not previously been filed with the Commission. If it is not practicable to file the Power of Attorney at the time of filing of the original report, it should be filed as soon as practicable as an amendment to the original filing. The Power of Attorney need not be filed with subsequent reports.