-------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION -----------------------------
FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
-------- -----------------------------
/ / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287
LONGER SUBJECT TO EXPIRES: JANUARY 31, 2005
SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN
FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5
CONTINUE. SEE Section 30(h) of the Investment Company Act of 1940 -----------------------------
INSTRUCTION 1(b).
(Print or Type Responses)
------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
Director 10% Owner
Penn Scott Weight Watchers International, Inc. ---- ----
--------------------------------------------------------------------------------------------- Officer (give Other
(Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for _X__ title ---- (specify
Number of Reporting Month/Day/Year below) below)
c/o Weight Watchers International, Inc. Person, if an entity Vice President Australasia
175 Crossways Park West (voluntary) 01/23/03 ----------------- ------------------
-------------------------------------------- --------------------- 7. Individual or Joint/Group Filing
(Street) 5. If Amendment, (Check Applicable Line)
Date of Original _X_Form filed by One Reporting Person
(Month/Day/Year) ___Form filed by More than One
Woodbury New York 11797 Reporting Person
------------------------------------------------------------------------------------------------------------------------------------
(City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
------------------------------------------------------------------------------------------------------------------------------------
1. Title of 2. Trans- 2A. Deemed 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
Security action Execution action or Disposed of (D) Securities ship of In-
(Instr. 3) Date Date, Code (Instr. 3, 4 and 5) Beneficially Form: direct
if any (Instr. 8) Owned Follow- Direct Bene-
(Month/ (Month/ ing Reported (D) or ficial
Day/ Day/ ------------------------------------------ Transaction(s) Indirect Owner-
Year) Year) (A) or (Instr. 3 (I) ship
Code V Amount (D) Price and 4) (Instr. 4) (Instr. 4)
------------------------------------------------------------------------------------------------------------------------------------
Common Stock, 01/23/03 M 65,875 A $2.125 291,492 D
no par value
------------------------------------------------------------------------------------------------------------------------------------
Common Stock, 01/23/03 M 16,469 A $2.125 87,583 I Through
no par value Spouse
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
-----------------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative Security 2. Conver- 3. Trans- 3A. Deemed 4. Transac- 5. Number of Deriv- 6. Date Exer-
(Instr. 3) sion or action Execution tion Code ative Securities Ac- cisable and Ex-
Exercise Date Date, (Instr. 8) quired (A) or Dis- piration Date
Price of (Month/ if any posed of (D) (Month/Day/
Deriv- Day/ (Month/ (Instr. 3, 4, and 5) Year)
ative Year) Day/
Security Year)
-------------------------------------- ----------------
Date Expira-
Exer- tion
Code V (A) (D) cisable Date
-----------------------------------------------------------------------------------------------------------------------------------
Options (right to buy) $2.125 01-23-03 M 65,875 See Note 1 12/17/09
-----------------------------------------------------------------------------------------------------------------------------------
Options (right to buy) $2.125 01-23-03 M 16,469 See Note 2 12/17/09
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------
7. Title and Amount of 8. Price of 9. Number of 10. Ownership 11. Nature of
Underlying Securities Derivative Derivative Form of Indirect
(Instr. 3 and 4) Security Securities Derivative Beneficial
(Instr. 5) Beneficially Securities: Ownership
Owned Direct (D) or (Instr. 4)
Following Indirect (I)
Reported (Instr. 4)
Transaction(s)
----------------------- (Instr. 4)
Title Amount or
Number of
Shares
-----------------------------------------------------------------------------------------------
Common Stock, 65,875 32,937 D
no par value
-----------------------------------------------------------------------------------------------
Common Stock, 16,469 8,235 I Through
no par value Spouse
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
/s/ Scott Penn 01/24/03
----------------------------------- -----------
Scott Penn 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).
Note: File three copies of this Form, one of which must be manually signed.
If space is insufficient, SEE Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently valid OMB Number.
Explanation of Responses:
Note 1: Options for 94,107 shares were granted to Mr. Penn on December 17, 1999 that
vest on the following schedule: 10% on December 17, 1999; 15% on December 30, 2000;
20% on December 29, 2001; 20% on December 28, 2008; 20% on January 3, 2003; and
15% on January 1, 2004. Options for 188,215 shares were granted on December 17, 1999
that, subject to meeting certain EBITDA targets, vest on the following schedule:
25% on December 30, 2000; 25% on December 29, 2001; 25% on December 28, 2002;
12.5% on January 3, 2003; and 12.5% on January 1, 2004.
Note 2: Options for 70,581 shares were granted on December 17, 1999 to the spouse
of Mr. Penn. 23,527 of these options vest on the following schedule: 10% on
December 17, 1999; 15% on December 30, 2000; 20% on December 29, 2001; 20% on
December 28, 2002; 20% on January 3, 2003; and 15% on January 1, 2004. 47,054 of
these options, subject to meeting certain EBITDA targets, vest on the following
schedule: 25% on December 30, 2000; 25% on December 29, 2001; 25% on December 28,
2002; 12.5% on January 3, 2003; and 12.5% on January 1, 2004.