UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
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 | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KUSIN GARY M 2280 N. GREENVILLE AVE. RICHARDSON, TX 75082 |
 X |  |  |  |
/s/ Randy S. Hyne, Attorney-in-Fact | 08/15/2011 | |
**Signature of Reporting Person | Date |
No securities are beneficially owned | |
* | 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). |
 Remarks: POWER OF ATTORNEY: KNOW ALL MEN BY THESE PRESENTS, that Gary M. Kusin hereby constitutes and appoints Randy S. Hyne as attorney-in-fact with power and authority to act on behalf of the undersigned as follows: To execute and file with the United States Securities and Exchange Commission Forms 3, 4, 5, and 144, and any amendments thereto, regarding transactions in Fossil, Inc. stock. Any person receiving a duly executed copy or facsimile of this instrument may rely on the authority of the attorney-in-fact as hereinabove set forth, and revocation or termination of this Power of Attorney by operation of law or otherwise shall be ineffective as to such person unless and until such person receives actual notice or knowledge of such revocation. IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this 11th day of August, 2011. /s/ Gary M. Kusin |