-----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, NFsfhxdYeFOFSbx5KYh52etGJ1cMjpc9hjnc4cfh7SXIE1MdBqU+IYxXm6jOcT2N yHa+qhTEEOtFkqOhLdeVlQ== 0000950130-96-004779.txt : 19961217 0000950130-96-004779.hdr.sgml : 19961217 ACCESSION NUMBER: 0000950130-96-004779 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19961216 SROS: NASD 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: 1934 Act SEC FILE NUMBER: 000-28492 FILM NUMBER: 96681178 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: RANDALL RICHARD D CENTRAL INDEX KEY: 0001029026 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] OFFICER STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 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 4 1 FORM U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 OMB APPROVAL ----------------------------- [_] Check this box if no longer OMB NUMBER: 3235-0287 subject to Section 16. Form 4 Expires: September 30, 1998 or Form 5 obligations may Estimated average burden continue. SEE Instruction 1(b). hours per response ...... 0.5 ----------------------------- 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(f) of the Investment Company Act of 1940 1. Name and Address of Reporting Person Randall Richard D. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 81 Winslow Road - -------------------------------------------------------------------------------- (Street) Westwood MA 02090 - -------------------------------------------------------------------------------- (City) (State) (Zip) Innovasive Devices, Inc. IDEA - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol ###-##-#### - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) October 1996 - -------------------------------------------------------------------------------- 4. Statement for Month/Year - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) Director 10% Owner ----- ------ X Officer (give Other (Specify ----- title below) ------ below) President and CEO ---------------------------------- - -------------------------------------------------------------------------------- 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 1 -- 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. Ownership 7. Nature (Instr. 3) action action or Disposed of (D) Securities Form: of Indirect Date Code Beneficially Direct Beneficial (Instr. 8) (Instr. 3,4 and 5) Owned at (D) or Ownership (Month/ ------------ -------------------------- End of Month Indirect (Instr. 4) Day/ Code V Amount (A) or Price (Instr. 3 (I) Year) (D) and 4) (Instr. 4) - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- Common Stock 10/29/96 P 10,000 A $6.875 163,051 D - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) The preceding statement Form 4 for October 1996 was required to be filed on November 8, 1996. (Over) SEC 1473 (8-92) ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 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 Security 2. Conversion 3. Transaction 4. Transacation 5. Number of Derivative 6. Date Exercisable (Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date Derivative Year) (Instr. 3, 4, and 5) (Month/Day/ Security Year) --------------- -------------------------- ------------------- Code V (A) (D) Date Expiration Exer- Date cisable - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership (Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4) Instr. 4) Indirect (I) (Instr. 4) - ------------------------ Title Amount or Number of Shares - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
Explanation of Responses: See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. 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 unless the form displays a currently valid OMB Number. /s/ Richard D. Randall 11/11/96 _______________________________ ______________ **Signature of Reporting Person Date Page 2 SEC 1474 (8-92) -----END PRIVACY-ENHANCED MESSAGE-----