OMB APPROVAL
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OMB Number 3235-0362
-------- Expires: January 31, 2005
FORM 5 U.S. SECURITIES AND EXCHANGE COMMISSION Estimated average burden
-------- Washington, D.C. 20549 hours per response.. 1.0
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[ ] Check box if no longer subject
to Section 16. Form 4 or Form 5
obligations may continue.
See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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1. Name and Address of Reporting Person*
Feldberg Meyer
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(Last) First) (Middle)
Columbia University, Uris Hall, 3022 Broadway
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(Street)
New York NY 10027
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Select Medical Corporation - NYSE (SEM)
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3. IRS Identification Number of Reporting
Person, if an Entity (Voluntary)
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4. Statement for Month/Year
December 31, 2002
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5. If Amendment, Date of Original (Month/Year)
/ /
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6. Relationship of Reporting Person(s)
to Issuer
(Check all applicable)
[X] Director [ ] 10% Owner
[ ] Officer (give title [ ] Other (specify
below) below)
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7. Individual or Joint/Group Reporting
(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, Acquired,
Disposed of, or Beneficially Owned
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1. Title of Security 2. Transaction 2A. Deemed 3. Transaction 4. Securities 5. Amount of 6.Ownership Form: 7.Nature of
(Instr. 3) Date (Month/ Execu- Code Acquired (A) Securities Direct (D) or Indirect
Day/Year) tion Date, (Instr. 8) or Disposed of Beneficially Indirect (I) Beneficial
if any (D) (Instr. 3, Owned at the (Instr. 4) Ownership
(Month/ 4 and 5) end of Issuer's (Instr. 4)
Day/ Fiscal
Year) Year (Instr.
3 and 4)
Amount (A) Price
or
(D)
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* If the form is filed by more than one reporting person, see instruction
4(b)(v).
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FORM 5 (Continued)
Table II - Derivative Securities Acquired, Disposed of,
or Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
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1.Title of 2.Conver- 3.Trans- 3A.Deemed 4.Transac- 5.Number 6.Date 7.Title 8.Price 9.Number 10. Owner- 11.Nature
Deriva- sion or action Execu- tion of Exer- and of of ship of
tive Exercise Date tion Code Deriv- cisable Amount Deriv- Deriv- of De- Indirect
Sec- Price of (Month/ Date, if (Instr. ative and Ex- of ative ative rivative Bene-
urity Deriv- Day/ any 8) Secur- pira- Under- Secur- Secur- Secu- ficial
(Instr. 3) ative Year) (Month/ ities tion lying ity ities rity: Owner-
Security Day/ Ac- Date Secur- (Instr. Bene- Direct ship
Year) quired (Month/ ities 5) ficially (D) or (Instr.
(A) or Day/ (Instr. Owned at Indirect 4)
Disposed Year) 3 and 4) End of (I)
of (D) Year (Instr. 4)
(Instr. (Instr.
3, 4 and 4)
5)
(A) (D) Date Ex- Title Amount
Ex- pir- or
erci- ation Number
sable Date of
Shares
Non-qualified $14.04 2/12/02 A 7,000 (1) 2/11/12 Common 7,000 7,000 (D)
Stock Options Stock
(right to buy)
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Explanation of Responses:
(1) The original option grant of 7,000 options vests over 5 years in equal
parts of 1/5th of the total per year, beginning on 2/12/03.
/s/ Meyer Feldberg 1/27/03
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** Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
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