4 1 troubh010203form4.htm FORM 4 Form 4

 

FORM 4

 

__ Check this box if no longer 
     subject to Section 16. Form 4
     or Form 5 obligations may 
     continue. See Instruction 1(b).

     (Print or Type Responses)

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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

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1.  Name and Address of Reporting Person*
       Troubh      Raymond

2.  Issuer Name and Ticker or Trading Symbol
Gentiva Health Services, Inc.   (GTIV)

6.  Relationship of Reporting Person(s) to Issuer
                     (Check all applicable)

_X__   Director                              ___ 10% Owner
_   __  Officer (give title below)     ___Other (specify below)

_                                                                           __

(Last)     (First)     (Middle)

110 Rockefeller Plaza   Rm 712

3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)

4.  Statement for Month/Day/Year
January 2, 2003

(Street)
New York, New York   10020

5.  If Amendment, Date of
 Original (Month/Year)

7.  Individual or Joint/Group Filing (Check Applicable Line)

_X__ Form filed by One Reporting Person
___ Form filed by More than 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)

2A. Deemed Execution Date, if any
(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 End of Month
    (Instr. 3 and 4)

6.  Ownership
   Form: Direct
   (D) or
    Indirect (I)
    (Instr. 4)

7.  Nature of
   Indirect
   Beneficial
   Ownership
   (Instr. 4)

Code

V

Amount

(A) or (D)

Price
       

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

   

  

  

  

  

  

  

  

  

  

  

   

  

  

  

  

  

  

  

  

  

  

   

  

  

  

  

  

  

  

  

  

  

    

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

   

  

  

  

  

  

  

  

  

  

  

   

  

  

  

  

  

  

  

  

  

  

   

  

  

  
 
  
  

 

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.
Transac-tion Date
(Month/
Day/Year)

3A.
 Deemed
 Execution
 Date, if
 any
 (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 Exerciseable
   and Expiration  Date
  (Month/Day/Year)

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 Month
    (Instr. 4)

10.Ownership
     Form of
     Derivative
     Securities
     Beneficially
     Owned at
     End of Month
     (Instr. 4)

11.Nature  of
     Indirect
     Beneficial
     Ownership
     (Instr. 4)

Code

V

(A)

(D)

Date Exercisable

Expiration Date

Title

Amount or Number of Shares

  Stock option

 8.74 1/02/03  

A

   

 7,500

  

1/02/04

1/02/13

Common stock

 7,500

  

 34,345 D

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

 

 
 
 
 

 

  /s/ John T. Price, Attorney-in-fact                 
**Signature of Reporting Person

              January  22, 2003                             
Date

 

Reminder:

Report on a separate line for each class of securities beneficially owned directly or indirectly.

*

If the form is filed by more than one reporting person, see Instruction 4(b)(v).

**

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