FORM 3 |
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION |
OMB APPROVAL |
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INITIAL 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 |
OMB
Number: 3235-0104 Filed By |
1. Name and Address of Reporting Person* Moon John C. |
2. Date of Event |
4. Issuer Name and
Ticker or Trading Symbol |
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(Last) (First) (Middle) Baxter International Inc. |
3. I.R.S. Identification
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5. Relationship of
Reporting Person(s) Corporate Vice President |
6. If Amendment, Date of Original (Month/Day/Year) November 20, 2002 |
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(Street) Deerfield, IL 60015 |
7. 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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(City) (State) (Zip) |
Table I Non-Derivative Securities Beneficially Owned |
1. Title of Security |
2. Amount of |
3. Ownership Form: |
4. Nature of Indirect
|
Common Stock, $1 par value |
34,732 |
D |
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Common Stock, $1 par value |
2,764.6 |
I |
By 401(k) Plan |
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). 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 |
FORM 3 (continued) |
Table II -
Derivative Securities Beneficially Owned |
1. Title of Derivative
Security |
2. Date Exercisable |
3. Title and Amount
of Securities |
4. Conversion or
|
5. Ownership Form |
6. Nature of Indirect
Beneficial Ownership |
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Date |
Expiration |
Title |
Amount or |
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Employee Stock Option Plan (Right to Buy) | 02.16.01 |
02.15.08 |
Common Stock $1 par value |
4,808 |
$26.8782 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.16.01 |
11.14.08 |
Common Stock $1 par value |
10,452 |
$29.2102 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.15.02 |
11.13.09 |
Common Stock $1 par value |
10,452 |
$31.4525 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.13.03 |
11.12.10 |
Common Stock $1 par value |
42,900 |
$41.3438 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.13.03 |
11.12.10 |
Common Stock $1 par value |
4,900 |
$41.3438 |
D |
|
Employee Stock Option Plan (Right to Buy) | 12.31.01 |
11.12.10 |
Common Stock $1 par value |
17,500 |
$41.3438 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.26.04 |
11.25.11 |
Common Stock $1 par value |
51,480 |
$49.54 |
D |
|
Employee Stock Option Plan (Right to Buy) | 11.17.05 |
11.16.12 |
Common Stock $1 par value |
36,000 |
$30.06 |
D |
|
Deferred Compensation Plan - Baxter Stock Fund(1) | Common Stock $1 par value(1) |
441.3(3) |
1-for-1 |
D |
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Explanation of Responses: (1) Reporting person allocated compensation deferred under Baxter's Deferred Compensation Plan ("Plan") to the Baxter Common Stock Fund notional investment alternative. The value of the reporting person's Plan account is based on the performance of the Baxter Common Stock fund and any other benchmark investment funds selected by the reporting person. Amounts deferred are not actually invested in the Baxter Common Stock Fund or Baxter common stock. |
By: /s/ William M. Link, Attorney-in-Fact for John C. Moon **Signature of Reporting Person |
April 14, 2003 Date |
**Intentional misstatements
or omissions of facts constitute Federal Criminal Violations. Note: File three
copies of this Form, one of which must be manually signed. 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.
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POWER OF ATTORNEY Know all by these presents, that the undersigned hereby constitutes and appoints each of Jan Stern Reed, Thomas J. Sabatino, Jr. and William M. Link, signing singly, the undersigned's true and lawful attorney- in-fact to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of Baxter International Inc., Baxter Healthcare Corporation or Baxter World Trade Corporation (collectively "Baxter") Forms 3, 4, 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder and Form 144 under Rule 144 under the Securities Act of 1933; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, 5, or 144 and complete and execute any amendment or amendments thereto, and timely file any such form with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is Baxter assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 and Rule 144 of the Securities Act of 1933. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, 5 and 144 with respect to the undersigned's holdings of and transactions in securities issued by Baxter, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 18 day of November, 2002. /s/ John C. Moon