-----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, ARvz70QgXFFSI7BJ9vO6emA6fShBVi5rpTyTJ6tfm13FVfbZ3uUMOquKS/cwA4HN 7K5xCKzZcpjdO+1XQtvd2g== 0000912057-02-000307.txt : 20020413 0000912057-02-000307.hdr.sgml : 20020413 ACCESSION NUMBER: 0000912057-02-000307 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990630 FILED AS OF DATE: 20020107 COMPANY DATA: COMPANY CONFORMED NAME: CHAMBERLAIN SALLY F AS TRUSTEE OF THE EDWARD P FLEISCHER TRU CENTRAL INDEX KEY: 0001047057 STANDARD INDUSTRIAL CLASSIFICATION: [] OTHER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O OSI SYSTEMS INC STREET 2: 12525 CHUDRON AVE CITY: HAWTHORNE STATE: CA ZIP: 70250 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OSI SYSTEMS INC CENTRAL INDEX KEY: 0001039065 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 330238801 STATE OF INCORPORATION: CA FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23125 FILM NUMBER: 2502529 BUSINESS ADDRESS: STREET 1: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 90250 BUSINESS PHONE: 3109780516 MAIL ADDRESS: STREET 1: 12525 CHADRON AVENUE CITY: HAWTHORNE STATE: CA ZIP: 90250 5 1 a2067182z5.htm FORM 5 Prepared by MERRILL CORPORATION
    FORM 5
/ / Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
/ / Form 3 Holdings Reported
/ / Form 4 Transactions Reported		   UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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*   2.   Issuer Name and Ticker or Trading Symbol   6.   Relationship of Reporting Person(s) to Issuer (Check all applicable)
    Sally F. Chamberlain, Trustee and Beneficiary of the Edward P. Fleischer and Sally F. Fleischer Family Trust       OSI Systems, Inc. "OSIS"                Director        10% Owner
 
           
    (Last)   (First)   (Middle)   3.   I.R.S Identification Number of Reporting Person, if an entity (voluntary)   4.   Statement for Month/Year            Officer
    (give title below)		    X  Other
    (specify below)
    2404 Via Siena               6/30/99       Former 10% Owner    
         
     
(Street)           5.   If Amendment, Date of Original (Month/Year)   7.   Individual or Joint/Group Reporting
(check applicable line)
     Form filed by One Reporting Person
 X  Form filed by More than
    La Jolla   CA   92037                       One Reporting Person
    (City)   (State)   (Zip)                            
                Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.   Title of Security
(Instr. 3)		   2.   Transaction Date
(Month/ Day/ Year)		   3.   Transaction Code
(Instr. 8)		   4.   Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)		   5.   Amount of Securities Beneficially Owned at the end of Issuer's Fiscal Year   6.   Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)		   7.   Nature of Indirect Beneficial Ownership
(Instr. 4)
                       
      (Instr. 3 and 4)                
                                Amount   (A) or (D)   Price                        
    Common Stock       1/8/99       S           10,000   D   10.875       955,853       D        
    Common Stock       1/11/99       S           10,000   D   10.63       945,853       D        
    Common Stock       1/12/99       S           5,000   D   10.50       940,853       D        
    Common Stock       1/20/99       S           4,000   D   10.50       936,853       D        
    Common Stock       6/8/99       S           9,000   D   5.06       927,853       D        
    Common Stock       6/21/99       S           18,579   D   5.00       909,274       D        
                                                                 
                                                                 
                                                                 
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).   (Over)
    SEC 2270 (3/99)

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 CONTROL NUMBER.

FORM 5 (Continued)   Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1.   Title of Derivative Security
(Instr. 3)		   2.   Conversion or Exercise Price of Derivative Security   3.   Transaction Date
(Month/Day/Year)		   4.   Transaction Code
(Instr. 8)		   5.   Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)		   6.   Date Exercisable and Expiration Date (Month/Day/Year)
                                   
     
                                        (A)   (D)       Date Exercisable   Expiration Date
7.   Title and Amount of Underlying Securities
(Instr. 3 and 4)		   8.   Price of Derivative Security
(Instr. 5)		   9.   Number of Derivative Securities Beneficially Owned at End of Year
(Instr. 4)		   10.   Ownership of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)		   11.   Nature of Indirect Beneficial Ownership
(Instr. 4)
   
                               
    Title   Amount or Number of Shares                                

Explanation of Responses:

        /s/ Sally F. Chamberlain   12/22/01
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).  
Sally F. Chamberlain, Trust beneficiary		  
**Signature of Reporting Person		  
Date
             
Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure.       Sally F. Chamberlain, Trustee of the Edward P. Fleischer
and Sally F. Fleischer Family Trust
             
            Page 2
SEC 2270 (7-97)

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