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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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. | |||
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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Option (Right to Buy) | $ 19.875 | 03/15/2005 | M | 12,500 | 12/15/2004(4) | 09/29/2009 | Common | 25,000 (4) | $ 0 (5) | 12,500 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CHAPMAN GEORGE L ONE SEAGATE SUITE 1500 TOLEDO, OH 43604 |
X | Chairman and CEO |
By: Erin C. Ibele Attorney-in-Fact For: George L. Chapman | 03/17/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(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). |
(1) | The sale transaction was pursuant to Mr. Chapman's 10b5-1 trading plan. |
(2) | George L. Chapman III SSB IRA Rollover Custodian. |
(3) | Account for son of George L. Chapman. |
(4) | Options for the purchase of 125,000 shares of common stock at $19.875 per share were granted to Mr. Chapman on September 29, 1999, which grant has previously been reported. The partial exercise of these options for the purchase of 100,000 shares has previously been reported. Of the remaining options, options for the purchase of 25,000 shares vested on December 15, 2004. |
(5) | The options were granted under the Health Care REIT, Inc. 1995 Stock Incentive Plan and had no acquisition price. |