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*
VALENTE LOUIS P

(Last) (First) (Middle)
C/O MKS INSTRUMENTS
SIX SHATTUCK ROAD

(Street)
ANDOVER MA 01810

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PALOMAR MEDICAL TECHNOLOGIES INC [ PMTI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman
3. Date of Earliest Transaction (Month/Day/Year)
02/12/2004
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
Common Stock 02/10/2004 M 125,488 A $3.1875 159,489 D
Common Stock 02/10/2004 M 50,000 A $1.9688 209,489 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
Incentive Stock Option (right to buy)(1) $1.9688 02/10/2004 M 50,000 02/01/2003(2) 01/31/2010 Common Stock 50,000 $0 0 D
Incentive Stock Option (right to buy)(1) $3.1875 02/10/2004 M 125,488 05/15/2002(3) 05/31/2009 Common Stock 125,488 $0 0 D
Incentive Stock Option (right to buy)(4) $1 (2) 04/03/2011 Common Stock 100,000 100,000 D
Incentive Stock Option (right to buy)(5) $5.05 (2) 07/21/2013 Common Stock 13,333 13,333 D
Non-Qualified Stock Option (right to buy)(4) $1 (2) 04/03/2011 Common Stock 8,333 8,333 D
Non-Qualified Stock Option (right to buy)(1) $1.9688 (2) 01/31/2010 Common Stock 100,000 100,000 D
Non-Qualified Stock Option (right to buy)(1) $3.1875 (3) 05/31/2009 Common Stock 74,512 74,512 D
Non-Qualified Stock Option (right to buy)(5) $5.05 (2) 07/21/2013 Common Stock 6,667 6,667 D
Explanation of Responses:
1. 1996 Stock Option Plan
2. The stock option is exercisable in three equal installments, commencing one year from date of grant.
3. The stock option is exercisable in five equal installments, commencing one year from date of hire.
4. 1993 Stock Option Plan
5. 1998 Stock Option Plan
By: Paul S. Weiner For: Louis P. Valente 02/12/2004
** 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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