-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, EpTnJcb76Cl+shTrJtrV115GtQd4mgr7ksGo76dUDRhAjj+cj67CRZ/8Qv9BGcMe umMD+awrV26zkAcVj5vTPQ== 0001193125-08-029379.txt : 20080213 0001193125-08-029379.hdr.sgml : 20080213 20080213164422 ACCESSION NUMBER: 0001193125-08-029379 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20080213 DATE AS OF CHANGE: 20080213 GROUP MEMBERS: PETERSON HOLDINGS, INC. GROUP MEMBERS: PETERSON PARTNERS, LTD. SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SRI SURGICAL EXPRESS INC CENTRAL INDEX KEY: 0001014041 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 593252632 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-50575 FILM NUMBER: 08605660 BUSINESS ADDRESS: STREET 1: 12425 RACETRACK ROAD CITY: TAMPA STATE: FL ZIP: 33626 BUSINESS PHONE: 8138919550 MAIL ADDRESS: STREET 1: 12425 RACETRACK ROAD CITY: TAMPA STATE: FL ZIP: 33626 FORMER COMPANY: FORMER CONFORMED NAME: STERILE RECOVERIES INC DATE OF NAME CHANGE: 19960511 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: PETERSON WAYNE R CENTRAL INDEX KEY: 0001250095 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: C/O SRI SURGICAL EXPRESS INC STREET 2: 1245 RACETRACK ROAD CITY: TAMPA STATE: FL ZIP: 33626 BUSINESS PHONE: 7277941414 MAIL ADDRESS: STREET 1: 2779 CAMDEN ROAD CITY: CLEARWATER STATE: FL ZIP: 33759 SC 13G/A 1 dsc13ga.htm SCHEDULE 13G AMENDMENT NO. 4 Schedule 13G Amendment No. 4

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

SCHEDULE 13G

 

UNDER THE SECURITIES EXCHANGE ACT OF 1934

(Amendment No. 4)

 

 

 

 

SRI/Surgical Express, Inc.

(Name of Issuer)

 

 

Common Stock

(Title of Class of Securities)

 

 

78464W104

(CUSIP Number)

 

 

December 31, 2007

(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

¨ Rule 13d-1(b)

x Rule 13d-1(c)

¨ Rule 13d-1(d)

 

 


CUSIP NO. 78464W104    Page 2 of 7

 

  1  

NAME OF REPORTING PERSON

 

            Wayne R. Peterson

   
  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ¨

(b)  ¨

   
  3  

SEC USE ONLY

 

   
  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

            United States of America

   

 

NUMBER OF  

SHARES  

BENEFICIALLY  

OWNED BY  

EACH  

REPORTING  

PERSON  

WITH  

 

 

  5    SOLE VOTING POWER

 

            57,108

 

  6    SHARED VOTING POWER

 

            718,953

 

  7    SOLE DISPOSITIVE POWER

 

            57,108

 

  8    SHARED DISPOSITIVE POWER

 

            718,953

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

            776,061

   
10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 

 

 

¨

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9

 

            12.0%

   
12  

TYPE OF REPORTING PERSON

 

            IN

   

 


CUSIP NO. 78464W104    Page 3 of 7

 

  1  

NAME OF REPORTING PERSON

 

            Peterson Partners, Ltd.

   
  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ¨

(b)  ¨

   
  3  

SEC USE ONLY

 

   
  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

            Colorado

   

 

NUMBER OF  

SHARES  

BENEFICIALLY  

OWNED BY  

EACH  

REPORTING  

PERSON  

WITH  

 

 

  5    SOLE VOTING POWER

 

            0

 

  6    SHARED VOTING POWER

 

            645,300

 

  7    SOLE DISPOSITIVE POWER

 

            0

 

  8    SHARED DISPOSITIVE POWER

 

            645,300

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

            645,300

   
10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 

 

 

¨

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9

 

            10.0%

   
12  

TYPE OF REPORTING PERSON

 

            PN

   

 


CUSIP NO. 78464W104    Page 4 of 7

 

  1  

NAME OF REPORTING PERSON

 

            Peterson Holdings, Inc.

   
  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ¨

(b)  ¨

   
  3  

SEC USE ONLY

 

   
  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

            Colorado

   

 

NUMBER OF  

SHARES  

BENEFICIALLY  

OWNED BY  

EACH  

REPORTING  

PERSON  

WITH  

 

 

  5    SOLE VOTING POWER

 

            0

 

  6    SHARED VOTING POWER

 

            645,300

 

  7    SOLE DISPOSITIVE POWER

 

            0

 

  8    SHARED DISPOSITIVE POWER

 

            645,300

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

            645,300

   
10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 

 

 

¨

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9

 

            10.0%

   
12  

TYPE OF REPORTING PERSON

 

            CO

   

 


   Page 5 of 7

 

Item 1.  

(a)

   Name of Issuer:      
     SRI/Surgical Express, Inc.      
Item 1.  

(b)

   Address of Issuer’s Principal Executive Offices:      
    

12425 Race Track Road

Tampa, Florida 33626

     
Item 2.  

(a)

   Name of Person Filing:      
     (1)    Wayne R. Peterson      
     (2)    Peterson Partners, Ltd.      
     (3)    Peterson Holdings, Inc.      
Item 2.  

(b)

   Address of Principal Business Office or if None, Residence:      
     (1)   

2779 Camden Road

Clearwater, Florida 33759

     
     (2)   

700 N. Colorado Blvd., PMB 323

Denver, Colorado 80206-4036

     
     (3)   

700 N. Colorado Blvd., PMB 323

Denver, Colorado 80206-4036

     
Item 2.  

(c)

   Citizenship:      
     (1)    United States of America      
     (2)    Colorado      
     (3)    Colorado      
Item 2.  

(d)

   Title of Class of Securities:      
     Common Stock      
Item 2.  

(e)

   Cusip Number:      
     78464W104      
Item 3.   Statements filed pursuant to Rule 13d-1(b), or 13d-2(b) or (c):   
  Not applicable.   


   Page 6 of 7

 

Item 4.    Ownership      
   (a)    Amount Beneficially Owned:      
      (1)    776,061*      
      (2)    645,300      
      (3)    645,300      
  

*  This amount includes (1) 42,608 shares of Common Stock owned by the Wayne R. Peterson Grantor Retained Annuity Trust, of which Mr. Peterson is trustee, (2) 42,609 shares of Common Stock owned by the Theresa A. Peterson Grantor Retained Annuity Trust, of which Mrs. Peterson, Mr. Peterson’s wife, is trustee, (3) 31,044 shares of Common Stock owned by Mr. and Mrs. Peterson as tenants by the entireties, and (4) 645,300 shares of Common Stock owned by Peterson Partners, Ltd., a Colorado limited partnership, of which Peterson Holdings, Inc., a Colorado corporation, is the general partner. Mr. and Mrs. Peterson jointly own all of the issued and outstanding voting stock of Peterson Holdings, Inc. This amount also includes 14,500 shares of Common Stock issuable on exercise of stock options held by Mr. Peterson that are currently exercisable.

     
   (b)    Percent of Class:      
      (1)    12.0%      
      (2)    10.0%      
      (3)    10.0%      
   (c)    Number of shares as to which such person has:      
  

(1):

           
      (i)    sole power to vote or to direct the vote:      
         57,108      
      (ii)    shared power to vote or to direct the vote:      
         718,953      
      (iii)    sole power to dispose or to direct the disposition of:      
         57,108      
      (iv)    shared power to dispose or to direct the disposition of:      
         718,953      
  

(2):

           
      (i)    sole power to vote or to direct the vote:      
         0      
      (ii)    shared power to vote or to direct the vote:      
         645,300      
      (iii)    sole power to dispose or to direct the disposition of:      
         0      
      (iv)    shared power to dispose or to direct the disposition of:      
         645,300      
  

(3):

           
      (i)    sole power to vote or to direct the vote:      
         0      
      (ii)    shared power to vote or to direct the vote:      
         645,300      
      (iii)    sole power to dispose or to direct the disposition of:      
         0      
      (iv)    shared power to dispose or to direct the disposition of:      
         645,300      
Item 5.    Ownership of Five Percent or Less of a Class:   
   Not applicable.   
Item 6.    Ownership of More than Five Percent on Behalf of Another Person:      
   Theresa A. Peterson, Mr. Peterson’s wife, has the power to direct the receipt of dividends from, or the proceeds from the sale of, (1) 42,609 shares of Common Stock owned by the Theresa A. Peterson Grantor Retained Annuity Trust, of which Mrs. Peterson is trustee, (2) 31,044 shares of Common Stock owned by Mr. and Mrs. Peterson as tenants by the entireties, which power is shared with Mr. Peterson, and (3) 645,300 shares of Common Stock owned by Peterson Partners, Ltd., which power is shared with Mr. Peterson.      
Item 7.    Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company:
   Not applicable.
Item 8.    Identification and Classification of Members of the Group:      
   Not applicable.      
Item 9.    Notice of Dissolution of Group:      
   Not applicable.      
Item 10.    Certification:      
   By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of such securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.      


   Page 7 of 7

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated: February 12, 2008

 

/s/ Wayne R. Peterson

      PETERSON PARTNERS, LTD.
WAYNE R. PETERSON      
      By:   Peterson Holdings, Inc., its general partner
      By:  

/s/ Wayne R. Peterson

        Wayne R. Peterson, President
PETERSON HOLDINGS, INC.      
By:  

/s/ Wayne R. Peterson

     
  Wayne R. Peterson, President      
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