-----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, TNy/Zl7yp1BY1XcJMcAWHQ9Iy6PBGhQctJ9KbKAh676weHeP0ByFKG6WwKxJiFUt 6hh6sxv7odMKc19EqbtGLQ== 0001179110-04-002749.txt : 20040209 0001179110-04-002749.hdr.sgml : 20040209 20040209123947 ACCESSION NUMBER: 0001179110-04-002749 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031227 FILED AS OF DATE: 20040209 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SCHEIN HENRY INC CENTRAL INDEX KEY: 0001000228 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 113136595 STATE OF INCORPORATION: DE FISCAL YEAR END: 1226 BUSINESS ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 6318425500X6867 MAIL ADDRESS: STREET 1: 135 DURYEA RD CITY: MELVILLE STATE: NY ZIP: 11747 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BERGMAN STANLEY M CENTRAL INDEX KEY: 0001008413 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27078 FILM NUMBER: 04576780 BUSINESS ADDRESS: STREET 1: C/O HENRY SCHEIN INC STREET 2: 135 DURYEA ROAD CITY: MELVILLE STATE: NY ZIP: 11747 BUSINESS PHONE: 5168435500 MAIL ADDRESS: STREET 1: C/O HENRY SCHEIN INC STREET 2: 135 DURYEA ROAD CITY: MELVILLE STATE: NY ZIP: 11747 5 1 edgar.xml FORM 5 - X0201 5 2003-12-27 0 0 0 0001000228 SCHEIN HENRY INC HSIC 0001008413 BERGMAN STANLEY M C/O HENRY SCHEIN, INC. 135 DURYEA ROAD MELVILLE NY 11747 1 1 0 0 Chairman, CEO and President Common Stock 2003-10-02 5 G 0 385 0 D 9654 D Common Stock 2003-10-02 5 G 0 10 0 D 9644 D Common Stock 2003-12-11 5 G 0 30 0 D 9614 D Common Stock 656739 I See Footnote Common Stock 4420 I See Footnote Common Stock 778 I See Footnote Gift, not applicable. Represent shares held by Stanley Bergman's wife and Lawrence O. Sneag as co-trustees of the Stanley M. Bergman Continuing Trust. Represent shares held by Lawrence O. Sneag, Stanley M. Bergman's wife or his sons as trustees of trusts for the benefit of immediate family members of Stanley M. Bergman or certain other persons, wherein Stanley M. Bergman is the grantor. Represent shares held directly by Stanley M. Bergman's sons. /s/Stanley M. Bergman 2004-02-09 -----END PRIVACY-ENHANCED MESSAGE-----