FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
|
1. Name and Address of Reporting Person*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 05/10/2012 |
3. Issuer Name and Ticker or Trading Symbol
MEDNAX, INC. [ MD ] |
|||||||||||||
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
5. If Amendment, Date of Original Filed
(Month/Day/Year) |
||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Table I - Non-Derivative Securities Beneficially Owned | |||
---|---|---|---|
1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 4,591.2698(1)(2) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
---|---|---|---|---|---|---|---|
1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Options (Right to Buy) | 02/25/2007 | 02/25/2014 | Common Stock | 10,000(3) | $32.63 | D | |
Stock Options (Right to Buy) | 06/01/2009 | 06/01/2016 | Common Stock | 4,063(4) | $44.7 | D | |
Stock Options (Right to Buy) | 06/01/2010 | 06/01/2017 | Common Stock | 3,000(5) | $57.09 | D | |
Stock Options (Right to Buy) | 06/02/2011 | 06/02/2018 | Common Stock | 3,000(6) | $55.43 | D |
Explanation of Responses: |
1. Includes 925 shares of restricted stock granted on June 1, 2009 pursuant to Issuer's 2008 Incentive Compensation Plan ("2008 ICP"), that will vest on June 1, 2012, 1,410 shares of restricted stock granted on June 1, 2010 pursuant to Issuer's 2008 ICP that will vest in equal installments on June 1, 2012 and June 1, 2013 and 1,596 shares of restricted stock granted on June 1, 2011 pursuant to the Issuer's 2008 ICP that will vest in three equal installments on June 1, 2012, June 1, 2013 and June 1, 2014. |
2. Includes 660.2698 shares acquired by the Reporting Person through the Issuer's Employee Stock Purchase Plan. |
3. Stock Options granted on May 7, 2004 pursuant to Issuer's 2004 Incentive Compensation Plan. |
4. Stock Options granted on June 1, 2006 pursuant to Issuer's 2004 Incentive Compensation Plan. |
5. Stock Options granted on June 1, 2007 pursuant to Issuer's 2004 Incentive Compensation Plan. |
6. Stock Options granted on June 2, 2008 pursuant to Issuer's 2008 Incentive Compensation Plan. |
/s/ Dominic J. Andreano | 05/11/2012 | |
** 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 5 (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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |