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
 
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1. Name and Address of Reporting Person*
Dolan Michael James

(Last) (First) (Middle)
C/O EXXON MOBIL CORP
5959 LAS COLINAS BLVD

(Street)
IRVING TX 75039-2298

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/01/2004
3. Issuer Name and Ticker or Trading Symbol
EXXON MOBIL CORP [ XOM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 52,446 D
Common Stock 5,996.0224 I By Savings Plan
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 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) 02/27/1999 02/27/2008 Common Stock 34,322 26.975 D
Employee Stock Option (Right to Buy) 02/26/2000 02/26/2009 Common Stock 34,322 31.7 D
Employee Stock Option (Right to Buy) 12/08/2000 12/08/2009 Common Stock 40,000 41.7812 D
Employee Stock Option (Right to Buy) 11/29/2001 11/29/2010 Common Stock 51,000 45.2188 D
Employee Stock Option (Right to Buy) 11/28/2002 11/28/2011 Common Stock 60,000 37.12 D
Explanation of Responses:
Michael J. Dolan 09/07/2004
** 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 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.
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