-----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, VRqla8N+gsV+XtxTVfOdmqZ5949euu1+FXE/22/JQ0wSYoRqwvtOkoks3if0SUHR KTinFxpMaqr0s8nd+wKmPA== 0000927016-99-003300.txt : 19990927 0000927016-99-003300.hdr.sgml : 19990927 ACCESSION NUMBER: 0000927016-99-003300 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990406 FILED AS OF DATE: 19990924 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INNOVASIVE DEVICES INC CENTRAL INDEX KEY: 0001003608 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 043132641 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-28492 FILM NUMBER: 99716841 BUSINESS ADDRESS: STREET 1: 734 FOREST ST CITY: MARLBOROUGH STATE: MA ZIP: 01752 BUSINESS PHONE: 5084346000 MAIL ADDRESS: STREET 1: 734 FOREST STREET CITY: MARLBOROUGH STATE: MA ZIP: 01752 COMPANY DATA: COMPANY CONFORMED NAME: PALEFSKY HOWARD D CENTRAL INDEX KEY: 0001094330 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] DIRECTOR STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 734 FOREST STREET CITY: MARLBOROUGH STATE: MA ZIP: 94025 BUSINESS PHONE: 5084608229X146 MAIL ADDRESS: STREET 1: 2700 SANA HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 FORM 4 +--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Palefsky Howard D. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 2700 Sand Hill Road - -------------------------------------------------------------------------------- (Street) Menlo Park CA 94025 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Innovasive Devices, Inc. ("IDEA") ----------------------------------- 3. IRS or Identification Number of Reporting Person if an entity (Voluntary) -------------- 4. Statement for Month/Year 4/99 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) ---------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check Applicable Line) ____ 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 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 4/6/99 A 8,000 A -- 10,500 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If this form is filed by more than one reporting person, see Instruction 4(b)(v). FORM 4 (continued) TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- Stock Option (Right to Buy) (1) $ 10.00 - ----------------------------------------------------------------------------------------------------------------------------- Stock option (Right to Buy) (1) $ 12.00 - ----------------------------------------------------------------------------------------------------------------------------- Stock Option (Right to Buy) (2) $ 9.375 - ----------------------------------------------------------------------------------------------------------------------------- Stock Option) Right to Buy (1) $ 9.375 - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)--CONTINUED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- Security (Instr. 3) cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of In- Date ative Secur- of De- direct (Month/Day/ Secur- ities rivative Bene- Year) ity Bene- Secu- ficial (Instr. ficially rity: Owner- -------------------------------------------- 5) Owned Direct ship Date Expira- Amount or at End (D) or (Instr. Exer- tion Title Number of of Indi- 4) cisable Date Shares Month rect (1) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option (7) (Right to Buy) (1) 6/26/97 6/26/06 Common Stock 10,000 10,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock option (Right to Buy) (1) 6/27/98 6/27/07 Common Stock 2,500 2,500 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option (Right to Buy) (2) 6/8/99 6/8/08 Common Stock 37,500 37,500 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option (Right to Buy) (1) 6/8/99 6/8/08 Common Stock 2,500 2,500 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Granted under the Company's 1996 Non-Employee Directors Stock Option Plan. (2) Granted under the Company's 1996 Omnibus Stock Plan. (3) The options vest in four equal annual statements beginning on the date stated. **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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. ------------------------------- ----------------- **Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----