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
 
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
PETIT HENRI

(Last) (First) (Middle)
343 STATE STREET

(Street)
ROCHESTER NY 14650

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/01/2003
3. Issuer Name and Ticker or Trading Symbol
EASTMAN KODAK CO [ EK ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Senior Vice President
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 9,441(1) 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
options (right to buy) 08/26/2006 11/26/2011 common stock 10,000 31.3 D
options (right to buy) 08/26/2006 11/26/2011 common stock 8,400 31.3 D
options (right to buy) 08/26/2006 11/26/2011 common stock 9,200 31.3 D
options (right to buy) 08/26/2006 11/26/2011 common stock 8,067 31.3 D
options (right to buy) 08/26/2006 11/26/2011 common stock 2,500 31.3 D
options (right to buy) 08/26/2006 02/25/2012 common stock 10,500 31.3 D
options (right to buy) 08/26/2006 02/25/2012 common stock 11,500 31.3 D
options (right to buy) 08/26/2006 02/25/2012 common stock 15,333 31.3 D
options (right to buy) 08/26/2006 02/25/2012 common stock 23,000 31.3 D
options (right to buy) 11/22/2006 05/21/2012 common stock 23,000 36.66 D
options (right to buy) 05/05/2007 11/04/2012 common stock 10,000 30.84 D
restricted stock units(2) (4) (4) common stock 8,215.01 (7) D
restricted stock units(3) (5) (5) common stock 2,165 (7) D
stock units(6) (6) (6) common stock 2,798.6 (7) D
Explanation of Responses:
1. 3,180 of these shares are restricted, with the restriction lapsing on 07/03/08.
2. These restricted stock units were awarded under the 93-95 cycle of the performance stock plan, including dividend equivalents.
3. These restricted stock units were awarded on 01/16/01, and include dividend equivalents.
4. These units were granted on 02/09/96; the restrictions lapse on the participant's 60th birthday.
5. These units were granted on 01/16/01; the restrictions lapse on 01/16/05.
6. These units were granted on 01/16/01.
7. These units convert on a one-for-one basis.
Remarks:
James M. Quinn, as attorney-in-fact for Henri Petit 10/03/2003
** 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.