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*
DOLAN THOMAS J

(Last) (First) (Middle)
800 LONG RIDGE ROAD
P. O. BOX 1600

(Street)
STAMFORD CT 06904

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
XEROX CORP [ XRX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Senior Vice President
3. Date of Earliest Transaction (Month/Day/Year)
01/02/2004
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
Common Stock 01/02/2004 J(6) 32,500 A $0.0(5) 71,137 D
Incentive Stock Rights 01/02/2004 J(6) 32,500 D $0.0(5) 0 D
Common Stock 01/02/2004 F(6) 11,660 D $0.0(5) 59,477 D
Incentive Stock Rights 01/02/2004 A(7)(8) 46,000 A $0.00(5) 46,000 D
Xerox Stock Fund 15,136.665(1) I Xerox Stock Fund
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
Stock Option $4.75 01/01/2002(2) 12/31/2010 Common Stock 121,500 121,500 D
Stock Option $10.365 01/01/2003(2) 12/31/2011 Common Stock 121,500 121,500 D
Stock Option $21.7812 01/01/2005 12/31/2009 Common Stock 40,000 40,000 D
Stock Option $25.8125 03/01/2003 12/31/2009 Common Stock 8,860 8,860 D
Stock Option $28.9063 01/01/1999 12/31/2004 Common Stock 2,630 2,630 D
Stock Option $36.7032 01/01/1999(3) 12/31/2005 Common Stock 40,054 40,054 D
Stock Option $46.875 01/01/1999(3) 12/31/2008 Common Stock 17,166 17,166 D
Stock Option $54.8594 01/01/2000(4) 12/31/2008 Common Stock 57,214 57,214 D
Stock Option $59.4375 01/01/2000(2) 12/31/2006 Common Stock 1,188 1,188 D
Stock Option $7.885 01/01/2004(2) 12/31/2012 Common Stock 121,500 121,500 D
Stock Option $13.685 01/02/2004 A 77,000 01/01/2005(2) 12/31/2011 Common Stock 77,000 $13.685 77,000 D
Explanation of Responses:
1. Units purchased in Xerox Stock Fund under Xerox Savings Plan. Amount does not represent shares of stock, but dollars invested divided by unit value.
2. Options vest over three years, 33.3% per year beginning in year shown.
3. Options vest over three years, 33%, 33%, 34%, beginning in year shown.
4. Options vest over two years, 50% each year, beginning in year shown.
5. Not Applicable
6. Vesting of Incentive Stock Rights.
7. Incentive stock rights under 16b-3 plan payable in shares treated as restricted stock. These rights are subject to vesting requirements.
8. Restricted awards vest over three years, 33.3% per year beginning with 01/01/2005.
K. W. Fizer, Attorney-In-Fact 01/06/2004
** 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 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.
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.