SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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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*
DANKBERG MARK D

(Last) (First) (Middle)
6155 EL CAMINO REAL

(Street)
CARLSBAD CA 92009

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
VIASAT INC [ vsat ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
09/16/2003
4. 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 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 Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Prepaid Forward Contract (right of obligation to sell)(1) (1) 09/16/2003 J(1) 0(1)(2)(1) (1) 03/16/2005(1) common stock 125,000(1) (1) 0(1)(2) D
Explanation of Responses:
1. On September 16, 2003, Mr. Dankberg and his wife entered into a prepaid forward contract ("Contract") with respect to 125,000 shares of ViaSat, Inc. common stock ("Common Stock"). Subject to certain exceptions, on the settlement date, March 16, 2005, the Dankbergs will, at their option either (a) deliver up to 125,000 shares subject to the Contract or (b) retain all or a portion of such 125,000 shares and deliver the cash equivalent of any shares so retained. In consideration of the foregoing arrangement, the Dankbergs received aggregate proceeds of approximately $1,731,156. If the closing price of the Common Stock on the settlement date is greater than $15.50, the Dankberg's will be entitled to deliver a lesser number of shares (the value of which is equal to 125,000 multiplied by the difference between such closing price, up to a maximum closing price of $18.60, and $15.50) on settlement of the transaction.
2. The zeros in the above table are placeholders only that are required by the EDGAR software and should be disregarded.
Remarks:
Kathleen K. Hollenbeck, under power of attorney 09/17/2003
** 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 4 (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).
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