-----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, Km0WyGI4Z4c88G4XdDG263bYdgvklJYzfB8tc8Z5dR6pstKTALB5ejtoz+JJ+6xd umeQtQeuYtCE8n00NWoBLg== 0000010427-03-000052.txt : 20030203 0000010427-03-000052.hdr.sgml : 20030203 20030203164631 ACCESSION NUMBER: 0000010427-03-000052 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020308 FILED AS OF DATE: 20030203 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: HAHS DWAIN L CENTRAL INDEX KEY: 0001188713 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: C/O BAUSCH & LOMB INC STREET 2: ONE BAUSCH & LOMB PLACE CITY: ROCHESTER STATE: NY ZIP: 14604 BUSINESS PHONE: 5853385888 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BAUSCH & LOMB INC CENTRAL INDEX KEY: 0000010427 STANDARD INDUSTRIAL CLASSIFICATION: OPHTHALMIC GOODS [3851] IRS NUMBER: 160345235 STATE OF INCORPORATION: NY FISCAL YEAR END: 1226 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-04105 FILM NUMBER: 03536871 BUSINESS ADDRESS: STREET 1: BAUSCH & LOMB INCORPORATED STREET 2: ONE BAUSCH & LOMB PLACE CITY: ROCHESTER STATE: NY ZIP: 14604-2701 BUSINESS PHONE: 5853386000 MAIL ADDRESS: STREET 1: ONE BAUSCH & LOMB PLACE STREET 2: P O BOX 54 CITY: ROCHESTER STATE: NY ZIP: 14604-2701 4/A 1 dh013103.txt DWAIN L. HAHS AMENDED FORM 4 1. Name and Address of Reporting Person Hahs, Dwain L. One Bausch & Lomb Place Rochester, NY 14604- 2. Issuer Name and Ticker or Trading Symbol Bausch & Lomb Incorporated (BOL) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 2/2002 R1 5. If Amendment, Date of Original (Month/Day/Year) 03/08/2002 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Senior Vice President 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 I -- 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. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ +-------+-----+-----------+------+----------+ Month | Indirect| Owner- | | | Year) |Code |V |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------+-----+-----------+------+----------+----------------+-----------+------------+ Common Stock 26793 D Class B Stock 02/26/2002 A V 3500 A $0.0000 D Class B Stock 02/26/2002 A V 6000 A $0.0000 D Class B Stock 02/26/2002 D V -8725 D $0.0000 D Class B Stock 02/26/2002 D 0 D $0.0000 25430 D
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ +------+--+-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) |Code |V |(A) |(D) |cisable |tion Date |Title |Shares |Security |Month |(I) |ship | +-------------+--------+----------+------+--+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Explanation of Responses: Forfeiture of restricted stock shares previously reported as beneficially owned by the reporting person. The Form 4 for the reporting person filed on March 8, 2002 reported a forfeiture of 900 shares of restricted stock. After reconciliation of the reported person's share ownership, it was found that the shares were not forfeited and that the reporting person still claims beneficial ownership of the 900 Class B shares of restricted stock.
SIGNATURE OF REPORTING PERSON /s/ Dwain L. Hahs DATE 02/03/2003
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