-----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, N3f3Fsj6EZX6barTikTy6hdpnY1qDAgQcEnw7+aQ6efIIxuXG+/i04DOHnTWBS6J Hd2JpqIcgAfHjpyHKp3Isw== 0001181431-09-050403.txt : 20091106 0001181431-09-050403.hdr.sgml : 20091106 20091106182408 ACCESSION NUMBER: 0001181431-09-050403 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091105 FILED AS OF DATE: 20091106 DATE AS OF CHANGE: 20091106 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Basta Steven L CENTRAL INDEX KEY: 0001417397 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33791 FILM NUMBER: 091166098 MAIL ADDRESS: STREET 1: 1875 S GRANT STREET SUITE 110 CITY: SAN MATEO STATE: CA ZIP: 94402 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BIOFORM MEDICAL INC CENTRAL INDEX KEY: 0001282393 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 391979642 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 1875S GRANT ST STREET 2: SUITE 110 CITY: SAN MATEO STATE: CA ZIP: 94402 BUSINESS PHONE: 650-286-4000 MAIL ADDRESS: STREET 1: 1875S GRANT ST STREET 2: SUITE 110 CITY: SAN MATEO STATE: CA ZIP: 94402 4 1 rrd256423.xml FORM 4 X0303 4 2009-11-05 0 0001282393 BIOFORM MEDICAL INC BFRM 0001417397 Basta Steven L 1875 SOUTH GRANT STREET, SUITE 200 SAN MATEO CA 94402 1 1 0 0 Chief Executive Officer Common Stock 2009-11-05 4 M 0 20000 0.45 A 942086 D Common Stock 2009-11-05 4 S 0 20000 4.0855 D 922086 D Employee Stock Option(Right to Buy) 0.45 2009-11-05 4 M 0 20000 0.45 D 2014-01-15 Common Stock 20000 5000 D The sale reported in this Form 4 was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on August 28, 2009. The sale price reported in this Form 4 was between the range of $4.07 per share and $4.10 per share. Full information regarding the number of shares sold at each separate price will be provided to the Commission staff upon request. The shares subject to this option vested and became exercisable as to 1/4 of the shares on each anniversary of 11/11/2003. /s/ Steven L Basta 2009-11-06 -----END PRIVACY-ENHANCED MESSAGE-----