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Form 3

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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1. Name and Address of Reporting Person*
HALVORSON DAN L

(Last) (First) (Middle)
9255 TOWNE CENTRE DRIVE
SUITE 225

(Street)
SAN DIEGO CA 92121-3030

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/30/2004
3. Issuer Name and Ticker or Trading Symbol
NOVATEL WIRELESS INC [ NVTL ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP Fin., Treasurer, Acting CFO
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)
Common Stock, $0.001 par value 66 D
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 Stock Option (Right to Buy) (1) 04/04/2010 Common Stock 4,000 40 D
Incentive Stock Option (Right to Buy) (2) 07/17/2011 Common Stock 1,000 17.85 D
Incentive Stock Option (Right to Buy) (2) 10/23/2011 Common Stock 1,333 15.3 D
Incentive Stock Option (Right to Buy) 04/30/2003 10/31/2012 Common Stock 2,723 2.23 D
Incentive Stock Option (Right to Buy) (3) 06/26/2013 Common Stock 79,539 2.65 D
Non-Qualified Stock Option (Right to Buy) (3) 06/26/2013 Common Stock 17,738 2.65 D
Explanation of Responses:
1. 25% of the shares subject to the option vests and becomes exercisable on the first anniversary of grant and 1/3 of the remaining balance vests and becomes exercisable on each anniversary thereafter.
2. 25% of the shares subject to the option vests and becomes exercisable on the first anniversary of grant and 1/36th of the remaining balance vests and becomes exercisable each month thereafter.
3. 20% of the shares subject to the option vests and becomes exercisable 6 months following grant and 1/30th of the remaining balance vests and becomes exercisable each month thereafter.
/s/ Patrick T. Waters, Attorney-in-Fact 02/06/2004
** 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.