-----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, AYxes96rckpR4iemheJvr4u59lt5YBY5J10TM3PeYzP3S2uC3ncZNLP+Kh1K6hfW ze1ehhbt3QZtacwEUS7g6Q== 0001209191-05-008741.txt : 20050211 0001209191-05-008741.hdr.sgml : 20050211 20050211173939 ACCESSION NUMBER: 0001209191-05-008741 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050211 DATE AS OF CHANGE: 20050211 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LCA VISION INC CENTRAL INDEX KEY: 0001003130 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 112882328 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7840 MONTGOMERY RD CITY: CINCINNATI STATE: OH ZIP: 45236 BUSINESS PHONE: 5137929292 MAIL ADDRESS: STREET 1: 7840 MONTGOMERY ROAD CITY: CINCINNATI STATE: OH ZIP: 45236 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JOFFE STEPHEN N CENTRAL INDEX KEY: 0001030711 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27610 FILM NUMBER: 05600498 BUSINESS ADDRESS: STREET 1: 7840 MONTGOMERY RD CITY: CINCINNATI STATE: OH ZIP: 45236 BUSINESS PHONE: 5137929292 MAIL ADDRESS: STREET 1: 7840 MONTGOMERY ROAD CITY: CINCINNATI STATE: OH ZIP: 45236 5 1 bci12084_bco1.xml MAIN DOCUMENT DESCRIPTION X0202 5 2004-12-31 0 0 0001003130 LCA VISION INC LCAV 0001030711 JOFFE STEPHEN N 7840 MONTGOMERY ROAD CINCINNATI OH 45236 1 1 0 0 Chairman & CEO Common Stock 2005-01-11 5 G 0 213616 0 D 640848 I By spouse's GRAT dated 12-31-02 Common Stock 2005-01-13 5 G 0 640848 0 D 0 I By spouse's GRAT dated 12-31-02 Common Stock 2005-01-13 5 G 0 1212300 0 D 0 I By GRAT dated 12-31-02 Common Stock 83324 D All share amounts reflect a 3-for-2 stock split of LCA-Vision Common Stock on December 15, 2004. Beneficial ownership reflects post year-end gift transactions being voluntarily reported on this Form 5. Required distributions in the form of gifts from reporting person's and spouse's GRATs upon their termination as of December 31, 2004 to adult family members not living in reporting person's household. Jointly with spouse. Reflects distribution from spouse's GRAT to joint ownership and resulting change from indirect to direct ownership. /s/ Patricia O. Lowry, Attorney-in-fact for Stephen N. Joffe 2005-02-11 -----END PRIVACY-ENHANCED MESSAGE-----