-----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, R0KZIBhXwyfev6MBi51VfiOCIh9nnAvzHowJ/nIdY2750g4PaiNukpd1214wGiOL Iuc3Kh2JNVcZtE6VcoO0BA== 0000891836-02-000235.txt : 20020502 0000891836-02-000235.hdr.sgml : 20020501 ACCESSION NUMBER: 0000891836-02-000235 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020502 FILED AS OF DATE: 20020502 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: QUINTON CARDIOLOGY SYSTEMS INC CENTRAL INDEX KEY: 0001166409 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 943300396 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-49755 FILM NUMBER: 02632019 BUSINESS ADDRESS: STREET 1: 3303 MONTE VILLA PKWY CITY: BOTHELL STATE: WA ZIP: 98021 BUSINESS PHONE: 4254022000 FORMER COMPANY: FORMER CONFORMED NAME: QUINTON HOLDING CORP DATE OF NAME CHANGE: 20020201 COMPANY DATA: COMPANY CONFORMED NAME: KONINKLIJKE PHILIPS ELECTRONICS NV CENTRAL INDEX KEY: 0000313216 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC & OTHER ELECTRICAL EQUIPMENT (NO COMPUTER EQUIP) [3600] OWNER STATE OF INCORPORATION: P7 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: REMBRANDT TOWER AMSTELPLEIN 1 STREET 2: 1096 HA AMSTERDAM CITY: THE NETHERLANDS BUSINESS PHONE: 0113140791 MAIL ADDRESS: STREET 1: REMBRANDT TOWER AMSTELPLEIN 1 STREET 2: 1096 HA AMSTERDAM CITY: THE NETHERLANDS FORMER COMPANY: FORMER CONFORMED NAME: PHILIPS NV DATE OF NAME CHANGE: 19910903 FORMER COMPANY: FORMER CONFORMED NAME: PHILIPS ELECTRONICS N V DATE OF NAME CHANGE: 19930727 3 1 sc0124-02.txt FORM 3 ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0104 Expires: January 31, 2005 Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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* Koninklijke Philips Electronics N.V. ----------------------------------------------------------------------------- (Last) (First) (Middle) Breitner Center Amstelplein 2 ----------------------------------------------------------------------------- (Street) 1096 BC Amsterdam The Netherlands ----------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) May 2, 2002 ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Quinton Cardiology Systems, Inc. (QUIN) ________________________________________________________________________________ 5. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [_] Form Filed by One Reporting Person [X] Form Filed by More than One Reporting Person ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 8 (1) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
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 5(b)(v). 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. (Over) (SEC 1473 (3/99) Page 1 of 4 FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Series A Preferred Stock Common Stock 2,617,977 1-for-1 (1) Immediate (2) (2) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: (1) These shares are owned directly by Philips Electronics North America Corporation ("PENAC"), a wholly owned subsidiary of Philips Holding USA Inc. ("PHUSA"). PHUSA is a wholly owned subsidiary of Koninklijke Philips Electronics N.V. ("KPNV"). Accordingly, securities owned by PENAC may be regarded as being owned beneficially by PHUSA; securities owned by PHUSA may be regarded as being owned beneficially by KPNV. (2) Does not reflect a 1-for-2.2 reverse stock split, to be effective upon the closing of the Issuer's initial public offering, pursuant to which each share of Series A Preferred Stock will convert into 1/2.2 of a share of Common Stock. Koninklijke Philips Electronics N.V. By: /s/ A. Westerlaken May 1, 2002 ------------------------------------ --------------- Name: A. Westerlaken Date Title: General Secretary **Signature of Reporting Person ** 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. 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 Number. Page 2 of 4 Joint Filer Information Name: Philips Electronics North America Corporation Address: 1251 Avenue of the Americas New York, NY 10020 Designated Filer: Koninklijke Philips Electronics N.V. Issuer & Ticker Symbol: Quinton Cardiology Systems, Inc. (QUIN) Date of Event Requiring Statement: May 2, 2002 Signature: /s/ William E. Curran ----------------------------- Name: William E. Curran Title: President and Chief Executive Officer Page 3 of 4 Joint Filer Information Name: Philips Holdings USA Inc. Address: 1251 Avenue of the Americas New York, NY 10020 Designated Filer: Koninklijke Philips Electronics N.V. Issuer & Ticker Symbol: Quinton Cardiology Systems, Inc. (QUIN) Date of Event Requiring Statement: May 2, 2002 Signature: /s/ William E. Curran ----------------------------- Name: William E. Curran Title: President and Chief Executive Officer Page 4 of 4 -----END PRIVACY-ENHANCED MESSAGE-----