United States
Securities and Exchange Commission
Washington D.C. 20549
Schedule 13G
Under the Securities Exchange Act of 1934
(Amendment No. 11)
FOSSIL, INC.
(Name of Issuer)
Common Stock, Par Value $.01
(Title of Class of Securities)
349882100
(CUSIP Number)
December 31, 2003
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
[ ] Rule 13d-1(b)
[ ] Rule 13d-1(c)
[X] Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section but shall
be subject to all other provisions of the Act (however, see the Notes).
Cusip No. 349882100 Page 2 of 4
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1 Names of Reporting Persons
I.R.S. Identification Nos. of Above Person (entities only)
Tom Kartsotis
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2 Check the Appropriate Box if a Member of A Group
(See Instructions)
(a) [ ]
(b) [ ]
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3 SEC Use Only
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4 Citizenship or Place of Organization
United States of America
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Number of 5 Sole Voting Power
10,469,816(1)
Shares --------------------------------------------
6 Shared Voting Power
Beneficially 0
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Owned by 7 Sole Dispositive Power
10,469,816(1)
Each Reporting --------------------------------------------
8 Shared Dispositive Power
Person With 0
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9 Aggregate Amount Beneficially Owned by Each Reporting Person
10,469,816(1)
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10 Check if the Aggregate Amount in Row (9) Excludes Certain Shares*
[X]
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11 Percent of Class Represented by Amount in Row (9)
22.5%(2)
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12 Type of Reporting Person*
IN
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* SEE INSTRUCTIONS BEFORE FILLING OUT!
Cusip No. 349882100 Page 3 of 4
Item 1(a) Name of Issuer:
Fossil, Inc.
Item 1(b) Address of Issuer's Principal Executive Offices:
2280 N. Greenville Avenue
Richardson, Texas 75082
Item 2(a) Name of Person Filing: Tom Kartsotis
Item 2(b) Address of Principal Business Office or, if none, Residence:
2280 N. Greenville Avenue
Richardson, Texas 75082
Item 2(c) Citizenship: United States of America
Item 2(d) Title of Class of Securities: Common Stock, par value $.01
Item 2(e) CUSIP No.: 349882100
Item 3 Not Applicable
Item 4 Ownership.
(a) Amount Beneficially Owned:
12,278,190(3)
(b) Percent of Class:
26.3%(2)
(c) Number of Shares as to Which the Person Has:
(i) sole power to vote or to direct the vote:
12,278,190(3)
(ii) shared power to vote or to direct the vote:
0
(iii) sole power to dispose or to direct the
disposition of: 12,278,190(3)
(iv) shared power to dispose or to direct the
disposition of: 0
Item 5 Ownership of Five Percent or less of a Class.
Not Applicable
(1) Includes 3,660,006 shares in grantor retained annuity trusts.
(2) Based on 46,625,401 shares issued and outstanding as of December 31,
2003.
(3) Includes 1,786,387 shares owned by Lynne Kartsotis, wife of Tom
Kartsotis, as to which Mr. Kartsotis disclaims beneficial ownership,
and 21,987 shares owned by Mr. Kartsotis as custodian for Annie Grace
Kartsotis, a minor.
Cusip No. 349882100 Page 4 of 4
Item 6 Ownership of More than Five Percent on Behalf of Another
Person.
Not Applicable
Item 7 Identification and Classification of the Subsidiary Which
Acquired the Security Reported on by the Parent Holding
Company.
Not Applicable
Item 8 Identification and Classification of Members of the Group.
Not Applicable
Item 9 Notice of Dissolution of Group.
Not Applicable
Item 10 Certification.
Not Applicable
Signature
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Date: January 22, 2004.
Signature: /s/ Tom Kartsotis
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