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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | 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 control number. | SEC 2270 (9-02) |
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 Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
EPSTEIN JEFFREY E 800 CONNECTICUT AVENUE NORWALK, CT 06854 |
 X |  |  |  |
/s/ Jeffrey E. Epstein | 02/14/2013 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | On July 6, 2011, Mr. Epstein made a charitable gift of 18 shares of priceline.com Incorporated common stock, par value $0.008 per share. |
(2) | On December 5, 2011, Mr. Epstein made a charitable gift of 200 shares of priceline.com Incorporated common stock, par value $0.008 per share. |
(3) | On May 14, 2012, Mr. Epstein made a charitable gift of 13 shares of priceline.com Incorporated common stock, par value $0.008 per share. |
(4) | On September 26, 2012, Mr. Epstein made a charitable gift of 15 shares of priceline.com Incorporated common stock, par value $0.008 per share. |
(5) | Includes, among other things, 2,459 shares of priceline.com common stock, the receipt of which have been deferred by Mr. Epstein. |