3 1 a2053603z3.txt FORM 3
-------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 3 WASHINGTON, D.C. 20549 OMB APPROVAL -------- ----------------------------- INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES OMB Number: 3235-0104 Expires: December 31, 2001 Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Estimated average burden Section 17(a) of the Public Utility Holding Company Act of 1935 or hours per response .... 0.5 (Print or Type Responses) Section 30(f) of the Investment Company Act of 1940 ----------------------------- ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event Re- 4. Issuer Name AND Ticker or Trading Symbol quiring Statement GE Fund (Month/Day/Year) InSight Health Services Corp. (IHSC) ------------------------------------------------- 6/25/01 ------------------------------------------------------------ (Last) (First) (Middle) 5. Relationship of Reporting Person(s) 6. If Amendment, Date ----------------------- to Issuer (Check all applicable) of Original 3. IRS or Social Se- Director X 10% Owner (Month/Day/Year) curity Number of ---- ---- 3135 Easton Turnpike Reporting Person Officer (give Other (specify --------------------- ------------------------------------------------- (Voluntary) title below) below) 7. Individual or (Street) 22-2621967 ---- ---- Joint/Group Filing (Check Applicable Line) --------------------------- Form filed by One X Reporting Person --- Form filed by More than One Reporting Person Fairfield Connecticut 06431 --- ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial (Instr. 4) Beneficially Owned Form: Direct Ownership (Instr. 5) (Instr. 4) (D) or Indirect (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Date Exer- 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of Indirect (Instr. 4) cisable and Underlying Derivative Security sion or ship Beneficial Expiration (Instr. 4) Exercise Form of Ownership Date Price of Deriv- (Instr. 5) (Month/Day/ Deri- ative Year) vative Security: -------------------------------------------------- Security Direct Amount (D) or Date Expir- or Indirect Exer- ation Title Number (I) cisable Date of Shares (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ Series C Convertible Preferred Stock (1) 6/25/01 None Common Stock 1,307,224 None D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) GE Fund has acquired, by means of a charitable donation from General Electric Company, 10,948 shares of Series C Convertible Preferred Stock. Under its terms, the Series C Convertible Preferred Stock is convertible into Common Stock or, under certain conditions, into shares of Series D Convertible Preferred Stock. The Series D Convertible Preferred Stock, in turn, is also convertible into Common Stock. Both the 10,948 shares of Series C Convertible Preferred Stock and the shares of Series D Convertible Preferred Stock issuable upon conversion of such 10,948 shares of Series C Convertible Preferred Stock are convertible into 1,307,224 shares of Common Stock. /s/ Eliza Fraser, Esq. July 5, 2001 ------------------------------------------ ------------------- Eliza Fraser, Esq., Counsel, on behalf of Date GE Fund **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. 2