-----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, GfnA8gpYZjIG97MHTgR1GIUSkLBx6dXtX7RqkfCbO0OANRz+n/Siqzv9CQBHshIV mA9FEg4Gy+Eh1pIbYcQGHQ== 0001001185-97-000041.txt : 19971211 0001001185-97-000041.hdr.sgml : 19971211 ACCESSION NUMBER: 0001001185-97-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971130 FILED AS OF DATE: 19971210 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: IDX SYSTEMS CORP CENTRAL INDEX KEY: 0001001185 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 030222230 STATE OF INCORPORATION: VT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-26816 FILM NUMBER: 97735330 BUSINESS ADDRESS: STREET 1: 1400 SHELBURNE RD STREET 2: PO BOX 1070 CITY: SOUTH BURLINGTON STATE: VT ZIP: 05403 BUSINESS PHONE: 8028621022 MAIL ADDRESS: STREET 1: 1400 SHELBURNE RD STREET 2: PO BOX 1070 CITY: SOUTH BURLINGTON STATE: VT ZIP: 05403 COMPANY DATA: COMPANY CONFORMED NAME: SAMPLE FRANK T CENTRAL INDEX KEY: 0001045147 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] OFFICER STATE OF INCORPORATION: VT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 1400 SHELBURNE RD STREET 2: PO BOX 1070 CITY: SOUTH BURLINGTON STATE: VT ZIP: 05403 BUSINESS PHONE: 8028621022 MAIL ADDRESS: STREET 1: 3535 207TH AVE SE CITY: ISSAQUAH STATE: WA ZIP: 98029 4 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. 1. Name and Address of Reporting Person(s) Sample, Frank T. P.O. Box 1070 1400 Shelburne Road Burlington, VT 05402-1070 2. Issuer Name and Ticker or Trading Symbol IDX Systems Corporation (IDXC) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 11/97 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Executive Vice President 7. 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 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code V Amount D Price End of Month I - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock (1) 11/07/97 M 10,000.00 A $5.8200 D Direct Common Stock (1) 11/07/97 S (2) 10,000.00 D $31.1250 D Direct Common Stock (1) 11/10/97 M 10,000.00 A $5.8200 D Direct Common Stock (1) 11/10/97 S (3) 10,000.00 D $32.0000 D Direct Common Stock (1) 11/11/97 M 27,880.00 A $5.8200 D Direct Common Stock (1) 11/11/97 S (2) 27,880.00 D $31.8330 D Direct Common Stock (1) 11/11/97 M 2,120.00 A $5.7500 D Direct Common Stock (1) 11/11/97 S (2) 2,120.00 D $31.8333 D Direct Common Stock (1) 11/17/97 M 4,709.00 A $5.7500 D Direct Common Stock (1) 11/17/97 S (2) 4,709.00 D $32.7500 D Direct Common Stock (1) 11/17/97 M 4,623.00 A $6.5800 D Direct Common Stock (1) 11/17/97 S (2) 4,623.00 D $32.7500 D Direct Common Stock (1) 11/17/97 M 2,676.00 A $6.5800 D Direct Common Stock (1) 11/17/97 S (2) 2,676.00 D $32.7500 D Direct Common Stock (1) 11/17/97 M 7,992.00 A $20.7200 D Direct Common Stock (1) 11/17/97 S (2) 7,992.00 D $32.7500 D Direct Common Stock (1) 11/20/97 M 8,389.00 A $20.7200 D Direct Common Stock (1) 11/20/97 S (2) 8,389.00 D $32.5000 D Direct Common Stock (1) 11/20/97 M 1,611.00 A $20.7200 D Direct Common Stock (1) 11/20/97 S (2) 1,611.00 D $32.5000 D Direct Common Stock (1) 11/21/97 M 3,907.00 A $20.7200 D Direct Common Stock (1) 11/21/97 S (2) 3,907.00 D $32.2500 D Direct Common Stock (1) 11/21/97 M 1,251.00 A $23.1900 D Direct Common Stock (1) 11/21/97 S (2) 1,251.00 D $32.2500 36,830.00 D Direct Common Stock 4,097.00 I By 401(k) Plan Table II (PART 1) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code V A D Exercisable Expiration - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Option (right to$5.7500 11/11/97 M 2,120.00 07/10/97 (4) 01/23/02 buy) (1) Employee Stock Option (right to$5.7500 11/17/97 M 4,709.00 07/10/97 (4) 01/23/02 buy) (1) Employee Stock Option (right to$5.8200 11/07/97 M 10,000.00 07/10/97 (4) 12/03/00 buy) (1) Employee Stock Option (right to$5.8200 11/10/97 M 10,000.00 07/10/97 (4) 12/03/00 buy) (1) Employee Stock Option (right to$5.8200 11/11/97 M 27,880.00 07/10/97 (4) 12/03/00 buy) (1) Employee Stock Option (right to$6.5800 11/17/97 M 4,623.00 07/10/97 (4) 02/03/04 buy) (1) Employee Stock Option (right to$6.5800 11/17/97 M 2,676.00 07/10/97 (4) 02/03/04 buy) (1) Employee Stock Option (right to$20.7200 11/17/97 M 7,992.00 07/10/97 (4) 01/30/07 buy) (1) Employee Stock Option (right to$20.7200 11/20/97 M 8,389.00 07/10/97 (4) 01/30/07 buy) (1) Employee Stock Option (right to$20.7200 11/20/97 M 1,611.00 07/10/97 (4) 01/30/07 buy) (1) Employee Stock Option (right to$20.7200 11/21/97 M 3,907.00 07/10/97 (4) 01/30/07 buy) (1) Employee Stock Option (right to$23.1900 11/21/97 M 1,251.00 07/10/97 (4) 01/27/05 buy) (1) Table II (PART 2) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Month - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Option (right to11/11/97 Common Stock (5) 2,120.00 D Direct buy) (1) Employee Stock Option (right to11/17/97 Common Stock (5) 4,709.00 0.00 D Direct buy) (1) Employee Stock Option (right to11/07/97 Common Stock (5) 10,000.00 $31.1250 D Direct buy) (1) Employee Stock Option (right to11/10/97 Common Stock (5) 10,000.00 $32.0000 D Direct buy) (1) Employee Stock Option (right to11/11/97 Common Stock (5) 27,880.00 0.00 D Direct buy) (1) Employee Stock Option (right to11/17/97 Common Stock (5) 4,623.00 D Direct buy) (1) Employee Stock Option (right to11/17/97 Common Stock (5) 2,676.00 1.00 D Direct buy) (1) Employee Stock Option (right to11/17/97 Common Stock (5) 7,992.00 D Direct buy) (1) Employee Stock Option (right to11/20/97 Common Stock (5) 8,389.00 D Direct buy) (1) Employee Stock Option (right to11/20/97 Common Stock (5) 1,611.00 D Direct buy) (1) Employee Stock Option (right to11/21/97 Common Stock (5) 3,907.00 1.00 D Direct buy) (1) Employee Stock Option (right to11/21/97 Common Stock (5) 1,251.00 16,999.00 D Direct buy) (1) Explanation of Responses: (1) Prior to the Effective Time of the Merger, the reporting person was a shareholder and optionee of PHAMIS and all of the reporting person's PHAMIS Common Stock and options for PHAMIS Common Stock have been converted into IDX Common Stock and options for IDX Common Stock. (2) Such shares being sold were acquired in a transaction exempt under Rule 16b-3(d). (3) Beneficial holdings reflected on this report do not include changes in the reporting person's holdings of securities resulting from the reporting person's participation in the issuer's qualified employee stock plan, since the last filing of a report disclosing transactions resulting from such participation. (4) Pursuant to the terms of the Agreement and Plan of Merger dated as of 3/25/97 (the 'Merger Agreement'), between PHAMIS, Inc. ('PHAMIS') and IDX Systems Corporation ('IDX'), all options became 100% vested and exercisable immediately prior the Merger. The Effective Time of the Merger was July 10, 1997 and all options became exercisable as of that date. (5) Pursuant to the terms of the Merger Agreement, the purchase price per share of IDX Common Stock is determined by dividing the purchase price per share of PHAMIS Common Stock subject to the PHAMIS option by the Conversion Ratio. For example, the reporting person was granted options for PHAMIS stock on 01/25/96 at a purchase price of $24.00 ($24.00/.73 = $32.88)
SIGNATURE OF REPORTING PERSON /S/ By: Robert W. Baker, Jr., Attorney-in-Fact For: Frank T. Sample DATE -----END PRIVACY-ENHANCED MESSAGE-----