-----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, PrI5etlZl7AUbEKsXyj30D/E6QraVD2qfsBa09hR7IXNdx54kIM4NplDRShTmGdE L7M8ZvebjRCPDXENcYyz0Q== 0001104659-03-014910.txt : 20030716 0001104659-03-014910.hdr.sgml : 20030716 20030716155551 ACCESSION NUMBER: 0001104659-03-014910 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20030716 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MEDICALCV INC CENTRAL INDEX KEY: 0001144284 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 411717208 STATE OF INCORPORATION: MN FISCAL YEAR END: 0430 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-62263 FILM NUMBER: 03789454 BUSINESS ADDRESS: STREET 1: 9725 SOUTH ROBERT TRAIL CITY: INVER GROVE HEIGHTS STATE: MN ZIP: 55077 BUSINESS PHONE: 6514523000 MAIL ADDRESS: STREET 1: 9725 SOUTH ROBERT TRAIL CITY: INVER GROVE HEIGHTS STATE: MN ZIP: 55077 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HAUSER PETER L CENTRAL INDEX KEY: 0001087019 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 16913 KINGS COURT CITY: LAKEVILLE STATE: MN ZIP: 55044 BUSINESS PHONE: 6125432821 MAIL ADDRESS: STREET 1: 16913 KINGS COURT CITY: LAKEVILLE STATE: MN ZIP: 55044 SC 13G 1 a03-1108_1sc13g.htm SC 13G

SEC 1745
(02-02)


Potential persons who are to 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.

 

 

UNITED STATES

OMB APPROVAL

 

SECURITIES AND EXCHANGE COMMISSION

OMB Number:
3235-0145

 

Washington, D.C. 20549

Expires: December 31, 2005

 

SCHEDULE 13G

Estimated average burden hours per response. . 11

 

Under the Securities Exchange Act of 1934
(Amendment No.    )*

 

MedicalCV, Inc.

(Name of Issuer)

 

Common Stock

(Title of Class of Securities)

 

584639 10 8

(CUSIP Number)

 

July 8, 2003

(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)

 

*The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

 

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 



 

CUSIP No.  584639 10 8

 

 

1.

Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only)
Peter L. Hauser

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

[     ]

 

 

(b)

[     ]

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With

5.

Sole Voting Power
869,557*

 

6.

Shared Voting Power
None

 

7.

Sole Dispositive Power
869,557*

 

8.

Shared Dispositive Power
None

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
869,557*

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  [     ]

 

 

11.

Percent of Class Represented by Amount in Row (9)
10.25%

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


*       Represents (a) 53,000 shares of common stock, (b) 37,500 units purchasable upon the exercise of warrants, each unit consisting of one share of common stock and one redeemable Class A Warrant to purchase one share of common stock, (c) 380, 357 shares of common stock purchasable upon the exercise of warrants and (d) 180,600 units held by the reporting person's IRA, each unit consisting of one share of common stock and one redeemable Class A Warrant to purchase one share of common stock.

 

2



 

Item 1.

 

(a)

Name of Issuer
MedicalCV, Inc.

 

(b)

Address of Issuer's Principal Executive Offices
9725 South Robert Trail
Inver Grove Heights, Minnesota 55077

 

Item 2.

 

(a)

Name of Person Filing
Peter L. Hauser

 

(b)

Address of Principal Business Office or, if none, Residence
16913 Kings Court
Lakeville, Minnesota  55044

 

(c)

Citizenship
United States

 

(d)

Title of Class of Securities
Common Stock, $0.01 par value

 

(e)

CUSIP Number
584639 10 8

 

Item 3.

If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

Not applicable

 

 

Item 4.

Ownership

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

 

(a)

Amount beneficially owned:    869,557

 

(b)

Percent of class:    10.25%

 

(c)

Number of shares as to which the person has:

 

 

(i)

Sole power to vote or to direct the vote    869,557

 

 

(ii)

Shared power to vote or to direct the vote    None

 

 

(iii)

Sole power to dispose or to direct the disposition of    869,557

 

 

(iv)

Shared power to dispose or to direct the disposition of    None

 

Item 5.

Ownership of Five Percent or Less of a Class

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [   ].

 

Item 6.

Ownership of More than Five Percent on Behalf of Another Person

Not applicable

 

3



 

Item 7.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person

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 the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

 

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.

 

 

July 16, 2003

 

Date

 


/s/ Peter L. Hauser

 

Signature

 


Peter L. Hauser

 

Name/Title

 

 

4


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