-----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, CRIRbUKZttpoRLFUzFzivBLwc4kCsjmqQvuf9CY98jSf6SNnTadLirsZggzYDYQr YYPfiP5IqwcoVYJVMkUANQ== 0001014739-05-000011.txt : 20050121 0001014739-05-000011.hdr.sgml : 20050121 20050121155630 ACCESSION NUMBER: 0001014739-05-000011 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050107 FILED AS OF DATE: 20050121 DATE AS OF CHANGE: 20050121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Palmer Juliet A CENTRAL INDEX KEY: 0001315076 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28740 FILM NUMBER: 05541641 BUSINESS ADDRESS: BUSINESS PHONE: 401-782-0702 MAIL ADDRESS: STREET 1: 33 NORTH ROAD CITY: WAKEFIELD STATE: RI ZIP: 02879 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MIM CORP CENTRAL INDEX KEY: 0001014739 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 050489664 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 CLEARBROOK RD CITY: ELMSFORD STATE: NY ZIP: 10523 BUSINESS PHONE: 914 460 1600 MAIL ADDRESS: STREET 1: 33 NORTH ROAD CITY: PEACE DALE STATE: RI ZIP: 02883 3 1 pal66.xml X0202 3 2005-01-07 0 0001014739 MIM CORP MIMS 0001315076 Palmer Juliet A 100 CLEARBROOK ROAD ELMSFORD NY 10523 0 1 0 0 Chief Financial Officer Common Stock, $.0001 par value 500 D Employee Stock Option (Right to buy) 12.2000 2011-11-28 Common Stock, $.0001 par value 17000 D Employee Stock Option (Right to Buy) 10.3100 2003-09-04 2012-09-04 Common Stock, $.0001 par value 5000 D Fully Exercisable Vests and becomes exercisable in three equal annual installments commencing on the first anniversary of the date of grant. /s/ Palmer, Juliet A 2005-01-21 -----END PRIVACY-ENHANCED MESSAGE-----