SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
EMERSON MARTIN J

(Last) (First) (Middle)
10700 BREN ROAD WEST

(Street)
MINNETONKA MN 55343

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AMERICAN MEDICAL SYSTEMS HOLDINGS INC [ AMMD ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President, CEO
3. Date of Earliest Transaction (Month/Day/Year)
02/24/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Voting Common Stock 02/24/2005 M 20,000 A $8.85 28,079.389(2)(3) D
Voting Common Stock 02/24/2005 S 20,000 D $40 8,079.389(2)(3) D
Voting Common Stock 02/25/2005 M 11,000 A $8.85 19,079.389(2)(3) D
Voting Common Stock 02/25/2005 S 11,000 D $39.7594 8,079.389(2)(3) D
Voting Common Stock 02/25/2005 M 47,500 A $8.3333 55,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 9,000 D $39.7594 46,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 5,000 D $39.7505 41,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 10,000 D $39.798 31,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 5,000 D $39.7702 26,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 10,000 D $39.712 16,579.389(2)(3) D
Voting Common Stock 02/25/2005 S 8,500 D $39.7041 8,079.389(2)(3) D
Voting Common Stock 02/28/2005 M 54,500 A $8.3333 62,579.389(2)(3) D
Voting Common Stock 02/28/2005 S 2,500 D $39.8077 60,079.389(2)(3) D
Voting Common Stock 02/28/2005 S 2,500 D $39.7778 57,579.389(2)(3) D
Voting Common Stock 02/28/2005 S 2,500 D $39.75 55,079.389(2)(3) D
Voting Common Stock 02/28/2005 S 7,500 D $39.3 47,579.389(2)(3) D
Voting Common Stock 02/28/2005 M 48,000 A $8.3333 95,579.389(2)(3) D
Voting Common Stock 02/28/2005 M 40,000 A $15.99 135,579.389(2)(3) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: 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
Employee Stock Option (right to buy) $8.85 02/24/2005 M 20,000 (1) 04/19/2011 Voting Common Stock 20,000 $8.85 11,000 D
Employee Stock Option (right to buy) $8.85 02/25/2005 M 11,000 (1) 04/19/2011 Voting Common Stock 11,000 $8.85 0 D
Employee Stock Option (right to buy) $8.3333 02/25/2005 M 47,500 (1) 06/29/2010 Voting Common Stock 47,500 $8.3333 54,500 D
Employee Stock Option (right to buy) $8.3333 02/28/2005 M 15,000 (1) 06/29/2010 Voting Common Stock 15,000 $8.3333 39,500 D
Employee Stock Option (right to buy) $8.3333 02/28/2005 M 39,500 (1) 06/29/2010 Voting Common Stock 39,500 $8.3333 0 D
Employee Stock Option (right to buy) $8.3333 02/28/2005 M 48,000 (1) 06/29/2010 Voting Common Stock 48,000 $8.3333 0 D
Employee Stock Option (right to buy) $15.99 02/28/2005 M 40,000 (1) 02/06/2013 Voting Common Stock 40,000 $15.99 36,663 D
Explanation of Responses:
1. Fully Vested.
2. Includes 6,079.389 share purchased under the Issuer's Employee Stock Purchase Plan.
3. Includes 127,500 shares of common stock that Mr. Emerson has agreed to transfer to his spouse pursuant to a Marital Termination Agreement, dated February 24, 2005. Mr. Emerson has also agreed to transfer to his spouse unvested options to purchase an aggregate of 69,989 shares of common stock pursuant to the Marital Termination Agreement. The Marital Termination Agreement is subject to court approval, and Mr. Emerson anticipates completing the transfer to his spouse of the foregoing shares of common stock and options to purchase common stock upon court approval of the Marital Termination Agreement.
Martin J. Emerson 02/28/2005
** Signature of Reporting Person Date
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 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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