|
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 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (right to buy) | $ 0.83 | (3) | 05/23/2012 | Common Stock | 100,000 | 0 | D | ||||||||
Stock Option (right to buy) | $ 4.45 | (4) | 03/16/2014 | Common Stock | 25,000 | 0 | D | ||||||||
Stock Option (right to buy) | $ 5.96 | (5) | 06/16/2015 | Common Stock | 15,000 | 0 | D | ||||||||
Stock Option (right to buy) | $ 6.87 | (6) | 06/20/2016 | Common Stock | 15,000 | 0 | D | ||||||||
Stock Option (right to buy) | $ 7.35 | (7) | 02/21/2017 | Common Stock | 12,000 | 0 | D | ||||||||
Stock Option (right to buy) | $ 2.75 | (9) | 02/18/2019 | Common Stock | 20,000 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KIRK SCOTT H MD C/O KIRK EYE CENTER 7427 LAKE STREET RIVER FOREST, IL 60305 |
X |
/s/ John W. Lawrence, Jr. by Power of Attorney | 02/24/2010 | |
**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) | Represents shares of common stock held by Kirk Eye Center, S.C., of which Dr. Kirk is a shareholder. Dr. Kirk disclaims beneficial ownership of these shares, except to the extent of his proportionate pecuniary interest therein. |
(2) | Represents shares of common stock held by Scott Kirk Family LLC. Dr. Kirk is the manager and a member of the LLC. Dr. Kirk disclaims beneficial ownership of these shares, except to the extent of his proportionate pecuniary interest therein. |
(3) | Subject to certain restrictions, 12,500 of these options vested on 11/23/02 with the remainder vesting 2,083 per month starting on 12/23/02. |
(4) | Subject to certain restrictions, 3,125 of these options vested on 9/16/04 with the remainder vesting 520 per month starting on 10/16/04. |
(5) | Subject to certain restrictions, 1,875 of these options vested on 12/17/05, with the remainder vesting 312 per month starting on 1/17/06. |
(6) | Subject to certain restrictions, 1,875 of these options vested on 12/20/06 with the remainder vesting 312 per month starting on 1/20/07. |
(7) | Subject to certain restrictions, 1,500 of these options vested on 8/21/07 with the remainder vesting 250 per month starting 9/21/07. |
(8) | Includes 22,898 restricted shares of common stock. |
(9) | Subject to certain restrictions, 2,500 of these options vested on 8/18/09 with the remainder vesting approximately 417 per month starting on 9/18/09. |
(10) | These shares were sold in multiple transactions ranging from 4.10 to 4.14, inclusive. The reporting person undertakes to provide to NovaMed, Inc., and security holder of NovaMed, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price in the foregoing range. |