SEC FORM
3
SEC Form 3
| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| 3900 WISCONSIN AVENUE, NW |
|
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
01/03/2005
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3. Issuer Name and Ticker or Trading Symbol
FEDERAL NATIONAL MORTGAGE ASSOCIATION FANNIE MAE
[ FNM ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| SVP & Interim Head of HCD |
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Common Stock |
8,942 |
D |
|
| Common Stock |
918.076 |
I |
By ESOP |
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Employee Stock Option (right to buy) |
11/18/1998
|
11/16/2007 |
Common Stock |
11,310 |
51.7188 |
D |
|
| Employee Stock Option (right to buy) |
11/17/1999
|
11/17/2008 |
Common Stock |
10,230 |
69.3125 |
D |
|
| Employee Stock Option (right to buy) |
11/16/2000
|
11/16/2009 |
Common Stock |
9,220 |
71.5 |
D |
|
| Employee Stock Option (right to buy) |
01/23/2004 |
01/18/2010 |
Common Stock |
16,536 |
62.5 |
D |
|
| Employee Stock Option (right to buy) |
11/21/2001
|
11/21/2010 |
Common Stock |
11,410 |
77.095 |
D |
|
| Employee Stock Option (right to buy) |
11/20/2002
|
11/20/2011 |
Common Stock |
13,080 |
80.95 |
D |
|
| Employee Stock Option (right to buy) |
01/21/2004
|
01/21/2013 |
Common Stock |
25,478 |
69.43 |
D |
|
| Employee Stock Option (right to buy) |
01/23/2005
|
01/23/2014 |
Common Stock |
27,622 |
78.315 |
D |
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| Explanation of Responses: |
|
| Remarks: |
|
|
/s/ Kenneth J. Bacon |
01/13/2005 |
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** 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
5
(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. |
LIMITED SIGNATORY POWER
By this Limited Signatory Power the
undersigned authorizes and designates each of Ann Kappler and Scott Lesmes
to execute and file on behalf of the undersigned all Forms 3, 4 and 5
(including any exhibits, attachments and amendments thereto) that the
undersigned may be required to file with the Securities and Exchange
Commission as a result of the undersigned's ownership of or transactions in
securities of Fannie Mae. The authority of Ann Kappler and Scott Lesmes
under this Limited Signatory Power shall continue until the undersigned is
no longer required to file Forms 3, 4 and 5 with regard to his or her
ownership of or transactions in securities of Fannie Mae, unless earlier
revoked in writing. The undersigned acknowledges that Ann Kappler and
Scott Lesmes are not assuming, nor is Fannie Mae assuming, any of the
undersigned's responsibilities to file Forms 3, 4 and 5 or otherwise comply
with any related laws or regulations.
/s/ Kenneth J. Bacon
___________________________________
Kenneth J. Bacon
Date:
January 11, 2005
