-----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, Lthd2D4CKTJM3nG1ZsASvE74M/TTfvyHPeBmYtsoHpEC16aFBfNMN2mEMz1iA7Kn 2Yf+3oF9k4SmY//ioohOtg== 0000950152-99-000986.txt : 19990215 0000950152-99-000986.hdr.sgml : 19990215 ACCESSION NUMBER: 0000950152-99-000986 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19990212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NCS HEALTHCARE INC CENTRAL INDEX KEY: 0001004990 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 341816187 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-47039 FILM NUMBER: 99537205 BUSINESS ADDRESS: STREET 1: 3201 ENTERPRISE PKWY STREET 2: STE 2200 CITY: BEACHWOOD STATE: OH ZIP: 44122 BUSINESS PHONE: 2165143350 MAIL ADDRESS: STREET 1: 1400 MCDONALD INVESTMENT CENTER STREET 2: 800 SUPERIOR AVE CITY: CLEVELAND STATE: OH ZIP: 44114 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SHAW KEVIN B CENTRAL INDEX KEY: 0001033796 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: C/O NCS HEALTHCARE INC STREET 2: 3201 ENTERPRISE PKWY STE 220 CITY: BEACHWOOD STATE: OH ZIP: 44122 BUSINESS PHONE: 2165143350 MAIL ADDRESS: STREET 1: 1400 MCDONALD INVESTMENT CENTER STREET 2: 800 SUPERIOR AVENUE CITY: CLEVELAND STATE: OH ZIP: 44114 SC 13G/A 1 NCS HEALTHCARE/KEVIN SHAW SCHEDULE 13G/AMENDED 1 SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 --------- SCHEDULE 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b), (c) AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2(b) (Amendment No. 2)(1) NCS HealthCare, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Class A Common Stock, $.01 par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 628874 10 9 - -------------------------------------------------------------------------------- (CUSIP Number) December 31, 1998 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) - -------- (1) The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). 2 - --------------------- ----------------- CUSIP NO. 628874 10 9 13G PAGE 2 OF 6 PAGES - --------------------- ----------------- - --------- ---------------------------------------------------------------------- 1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) Kevin B. Shaw - --------- ---------------------------------------------------------------------- 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] Not Applicable - --------- ---------------------------------------------------------------------- 3. SEC USE ONLY - --------- ---------------------------------------------------------------------- 4. CITIZENSHIP OR PLACE OF ORGANIZATION United States - --------- ---------------------------------------------------------------------- NUMBER OF 5. SOLE VOTING POWER 1,153,001 SHARES ----- ----------------------------------------------- BENEFICIALLY 6. SHARED VOTING POWER 5,675 OWNED BY ----- ----------------------------------------------- EACH 7. SOLE DISPOSITIVE POWER 1,153,001 REPORTING ----- ----------------------------------------------- PERSON WITH 8. SHARED DISPOSITIVE POWER 5,675 - -------------------------- ----- ----------------------------------------------- 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,158,676 - --------- ---------------------------------------------------------------------- 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [ ] Not Applicable - --------- ---------------------------------------------------------------------- 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 7.6% - --------- ---------------------------------------------------------------------- 12. TYPE OF REPORTING PERSON* IN - --------- ---------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! 3 ITEM 1(a). NAME OF ISSUER: NCS HealthCare, Inc. ------------------------------------------------------------- ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 3201 Enterprise Parkway, Suite 220, Beachwood, OH 44122 ------------------------------------------------------------- ITEM 2(a). NAME OF PERSON FILING: Kevin B. Shaw ------------------------------------------------------------- ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 3201 Enterprise Parkway, Suite 220, Beachwood, OH 44122 ------------------------------------------------------------- ITEM 2(c). CITIZENSHIP: United States ------------------------------------------------------------- ITEM 2(d). TITLE OF CLASS OF SECURITIES: Class A Common Stock, $.01 par value ------------------------------------------------------------- ITEM 2(e) CUSIP NUMBER: 628874 10 9 ------------------------------------------------------------- ITEM 3: IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR 13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A: (a) [ ] Broker or dealer registered under Section 15 of the Act, (b) [ ] Bank as defined in Section 3(a)(6) of the Act, (c) [ ] Insurance Company as defined in Section 3(a)(19) of the Act, (d) [ ] Investment Company registered under Section 8 of the Investment Company Act, (e) [ ] An investment adviser in accordance with Rule 13d-1(b)(l)(ii)(E), (f) [ ] An employee benefit plan or endowment fund in accordance with 13d-1(b)(1)(ii)(F), 4 (g) [ ] A parent holding company or control person in accordance with Rule 13d-1(b)(ii)(G), (h) [ ] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act, (i) [ ] A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act, (j) [ ] Group, in accordance with Rule 13d-1(b)(1)(ii)(J). Not Applicable If this statement is filed pursuant to Rule 13d-1(c), check this box.[] ITEM 4. OWNERSHIP. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 1,158,676 shares of Class A Common Stock (1)(2)(3) ----------------------------------------------------------------------------- (b) Percent of class: 7.6% ----------------------------------------------------------------------------- (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote 1,153,001 (1) --------------------------- (ii) Shared power to vote or to direct the vote 5,675 (2) ------------------------- (iii) Sole power to dispose or to direct the disposition of 1,153,001 (1) -------------- (iv) Shared power to dispose or to direct the disposition of 5,675 (2) ------------
Instruction. For computations regarding securities which represent a right to acquire an underlying security, see Rule 13d-3(d)(1). (1) Includes (a) 956,764 shares of Class B Common Stock, $.01 par value ("Class B Common Stock"), (b) 184,370 shares of Class B Common Stock held by a limited partnership of which the reporting person is sole general partner and (c) 6,667 shares of Class A Common Stock underlying options. Each share of Class B Common Stock is convertible at any time into one share of Class A Common Stock. (2) 5,675 shares of Class A Common Stock owned of record by the reporting person's wife. 5 (3) Assumes conversion of all shares of Class B Common Stock held by reporting person into shares of Class A Common Stock. ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [_]. Not Applicable ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not Applicable ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not Applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. Not Applicable ITEM 9. NOTICE OF DISSOLUTION OF GROUP. Not Applicable ITEM 10. CERTIFICATION. Not Applicable 6 SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 12, 1999 -------------------------------------- (Date) /s/ Kevin B. Shaw -------------------------------------- (Signature) Kevin B. Shaw/President & CEO -------------------------------------- (Name/Title) -----END PRIVACY-ENHANCED MESSAGE-----