-----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, DLYKH7jG309wWACww6fVkb5DK4+CMUgK1NLAVZr65Ibo5SP+xkHGb+WDH3Q9TutU +4WLzsgbO09qC8hp3Vo8fw== 0001209191-03-002697.txt : 20030429 0001209191-03-002697.hdr.sgml : 20030429 20030429154312 ACCESSION NUMBER: 0001209191-03-002697 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030429 FILED AS OF DATE: 20030429 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: EVANS DOUGLAS G CENTRAL INDEX KEY: 0001225164 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: KENSEY NASH CORP. STREET 2: 55 EAST UWCHLAN AVE. CITY: EXTON STATE: PA ZIP: 19341 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: KENSEY NASH CORP CENTRAL INDEX KEY: 0001002811 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 363316412 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27120 FILM NUMBER: 03669475 BUSINESS ADDRESS: STREET 1: MARSH CREEK CORPORATE CENTER STREET 2: 55 EAST UWCHLAN AVE STE 204 CITY: EXTON STATE: PA ZIP: 19341 BUSINESS PHONE: 6105947156 MAIL ADDRESS: STREET 1: 55 EAST UWCHLAN AVE STREET 2: STE 201 CITY: EXTON STATE: PA ZIP: 19341 4 1 i3071.htm FORM 4 SUBMISSION
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM 4

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935
or Section 30(h) of the Investment Company Act of 1940

o 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*
(Last, First, Middle)
2. Issuer Name and Ticker or
Trading Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Evans, Douglas , G.
  Kensey Nash Corporation (KNSY)
 
  55 East Uwchlan Ave.
4. Statement for Month/Day/Year 5. If Amendment, Date of Original (Month/Day/Year)
    04/29/2003
 
  (Street) 6. Relationship of Reporting Person(s)
to Issuer
(Check All Applicable)
7. Individual or Joint/Group Filing
(Check Applicable Line)
  Exton, PA 19341
(City)                (State)           (Zip)
  x  Director o  10% Owner   o Form filed by One Reporting Person
    x  Officer (give title below)   x Form filed by More than One Reporting Person
    o  Other (specify below)  
      COO
     

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).
 


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
Transactions(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   4/28/03   M(1)   200   A $8.75         D  

  Common Stock   4/28/03   S(1)   200   D $23.00         D  

  Common Stock             54,000     I   By Trust(2)

  Common Stock             350     I   By Child(3)

  Common Stock             350     I   By Child(3)

  Common Stock             350     I   By Child(3)

Page 2



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)

                      Code V   (A) (D)

  Employee Stock Options (rights to buy)   $8.75     4/28/03     M   200

  Employee Stock Options(rights to buy)            

  Employee Stock Options (rights to buy)            

  Employee Stock Options (rights to buy)            

  Employee Stock Options (rights to buy)            

  Employee Stock Options (rights to buy)            

  Employee Stock Options (rights to buy)            

  Employee Stock Options (rights to buy)            

Page 3

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned - Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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 of
Derivative Security:
Direct (D) or Indirect (I)

(Instr. 4)
11. Nature of
Indirect
Beneficial
Ownership

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

  5/9/99 5/9/05   Common Stock 87,200   $8.75       87,200     D  

  6/30/99 6/30/06   Common Stock 30,000   $13.375       30,000     D  

  7/23/00 7/23/07   Common Stock 30,000   $11.75       30,000     D  

  7/1/01 8/28/08   Common Stock 15,000   $7.625       15,000     D  

  (4) 4/9/09   Common Stock 170,000   $8.75       170,000     D  

  (5) 8/16/10   Common Stock 75,000   $13.13       75,000     D  

  (6) 6/5/11   Common Stock 133,200   $14.51       133,200     D  

  (7) 7/10/12   Common Stock 45,000   $14.58       45,000     D  

Explanation of Responses:

(1)The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person in April 2002.
(2)Shares held by Douglas G. Evans Revocable Trust, of which the Reporting Person is Trustee, for the benefit of Reporting Person and his spouse.
(3)Shares acquired by minor child of Reporting Person living in the same household as the Reporting Person.
(4)Subject to certain restrictions and to strike price restrictions not to exceed seven years, options to buy 170,000 shares were vested as of April 9, 2002.
(5)Subject to certain restrictions, options to buy 58,333 shares were vested on July 1, 2002 and the remaining 16,667 shares will vest on July 1, 2003.
(6)Subject to certain restrictions, options to buy 80,000 shares vested on December 5, 2001, options to buy 17,734 shares vested on June 5, 2002 and the remaining 35,466 shares will vest in two equal annual installments starting on June 5, 2003.
(7)Subject to certain restri ctions, options to buy 45,000 shares will vest in three equal annual installments starting on July 1, 2003.

/s/Douglas G. Evans, P.E.   4/29/2003

**Signature of Reporting Person
 
Date


**   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.
 

Page 4


Joint Filer Information
 
Designated Filer: Douglas Evans
Issuer and Ticket Symbol: Kensey Nash Corporation ("KNSY")
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

 
Name: (entity) Douglas G. Evans Revocable Trust
Address: 55 East Uwchlan Ave.
Exton, PA 19341
   
Ownership Form and Nature of Indirect
Ownership:
Indirect, By Trust
   
By: /s/ Douglas G. Evans, P.E.                  
Douglas G. Evans, Trustee
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