-----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, GI7sIVoqepAhrSWN0xJWVgF+DiBcD85ukqxJim3f2Y5TC11mrCqqV6P49yonF1tK Jb7hq0X3RNLI5EA9zAjgcg== 0000912057-97-004063.txt : 19970221 0000912057-97-004063.hdr.sgml : 19970221 ACCESSION NUMBER: 0000912057-97-004063 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970211 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ECLIPSE SURGICAL TECHNOLOGIES INC CENTRAL INDEX KEY: 0000863680 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 770223740 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-48997 FILM NUMBER: 97523971 BUSINESS ADDRESS: STREET 1: 1049 KIEL CT CITY: SUNNYVALE STATE: CA ZIP: 94089 BUSINESS PHONE: 4087470120 MAIL ADDRESS: STREET 1: 1049 KIEL COURT CITY: SUNNYVALE STATE: CA ZIP: 94089 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SHAHEEN TAWFEEK CENTRAL INDEX KEY: 0001032683 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 200 PETALUMA AVE CITY: SONOMA STATE: CA ZIP: 95476 BUSINESS PHONE: 7079968082 MAIL ADDRESS: STREET 1: 200 PETALUMA AVE CITY: SONOMA STATE: CA ZIP: 95476 SC 13G 1 SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. )* ------ Eclipse Surgical Technologies, Inc. ------------------------------------ (Name of Issuer) Common Stock ------------------------------------ (Title of Class of Securities) 278849 10 4 ------------------------------------ (CUSIP Number) Check the following box if a fee is being paid with this statement / /. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7.) *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 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). Page 1 of 4 Pages CUSIP No. 278849 10 4 13G Page 2 of 8 Pages --------- --- --- - ------------------------------------------------------------------------------- (1) Names of Reporting Persons. S.S. or I.R.S. Identification Nos. of Above Persons Tawfeek Shaheen ###-##-#### - ------------------------------------------------------------------------------- (2) Check the Appropriate Box if a Member (a) / / of a Group* (b) / / - ------------------------------------------------------------------------------- (3) SEC Use Only - ------------------------------------------------------------------------------- (4) Citizenship or Place of Organization United States - ------------------------------------------------------------------------------- Number of Shares (5) Sole Voting Beneficially Power 1,090,689 Owned by -------------------------------------------------- Each Reporting (6) Shared Voting Person With Power 0 -------------------------------------------------- (7) Sole Dispositive Power 1,090,689 -------------------------------------------------- (8) Shared Dispositive Power 0 - ------------------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 1,090,689 - ------------------------------------------------------------------------------- (10) Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares* - ------------------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 6.7% - ------------------------------------------------------------------------------- (12) Type of Reporting Person* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 4 Pages APPENDIX TO SCHEDULE 13G Tawfeek Shaheen ITEM 1(A). NAME OF ISSUER Eclipse Surgical Technologies, Inc. - ------------------------------------------------------------------------------- ITEM 1(B). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES 1049 Kiel Court, Sunnyvale, CA 94089 - ------------------------------------------------------------------------------- ITEM 2(A). NAME OF PERSON(S) FILING Tawfeek Shaheen - ------------------------------------------------------------------------------- ITEM 2(B). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE 200 Petaluma Avenue, Sonoma, CA 95476 - ------------------------------------------------------------------------------- ITEM 2(C). CITIZENSHIP United States - ------------------------------------------------------------------------------- ITEM 2(D). TITLE OF CLASS OF SECURITIES Common Stock - ------------------------------------------------------------------------------- ITEM 2(E). CUSIP NUMBER 278849 10 4 - ------------------------------------------------------------------------------- ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(B), OR 13D-2(B), CHECK WHETHER THE PERSON FILING IS A (a) / / Broker or Dealer registered under Section 15 of the Act (b) / / Bank as defined in section 3(a)(6) of the Act (c) / / Insurance Company as defined in section 3(a)(19) of the Act (d) / / Investment Company registered under section 8 of the Investment Company Act (e) / / Investment Adviser registered under section 203 of the Investment Advisers Act of 1940 (f) / / Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see Rule 13d-1(b)(1)(ii)(F) (g) / / Parent Holding Company, in accordance with Rule 13d-1(b)(ii)(G) (Note: See Item 7) (h) / / Group, in accordance with Rule 13d-1(b)(1)(ii)(H) ITEM 4. OWNERSHIP (a) Amount Beneficially Owned: 1,090,689 --------------------------------------------------------------------------- (b) Percent of Class: 6.7% --------------------------------------------------------------------------- (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote 1,090,689 ----------------------------------------------------------------- (ii) shared power to vote or to direct the vote 0 ----------------------------------------------------------------- (iii) sole power to dispose or to direct the disposition of 1,090,689 ----------------------------------------------------------------- (iv) shared power to dispose or to direct the disposition of 0 ----------------------------------------------------------------- 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. / / N/A Page 3 of 4 Pages ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON N/A ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY N/A ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP N/A ITEM 9. NOTICE OF DISSOLUTION OF GROUP N/A 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. February 7, 1997 ---------------------------------------- Date /s/ Tawfeek Shaheen ---------------------------------------- Signature Tawfeek Shaheen ---------------------------------------- Name/Title Page 4 of 4 Pages -----END PRIVACY-ENHANCED MESSAGE-----