-----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, KyzKg2oR+CdC2sEmuDlxC0CvRt2xYe68WdgghC+WcM1SqD3tDk6PLIRGUVIIOONK roZ2HnHVGCGhvMbK0aDCFQ== 0000351721-04-000014.txt : 20040120 0000351721-04-000014.hdr.sgml : 20040119 20040120152918 ACCESSION NUMBER: 0000351721-04-000014 CONFORMED SUBMISSION TYPE: 144 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040120 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: HAWARI KENNETH G CENTRAL INDEX KEY: 0001192861 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 144 MAIL ADDRESS: STREET 1: 6501 WINDCREST DR STREET 2: SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ADVANCED NEUROMODULATION SYSTEMS INC CENTRAL INDEX KEY: 0000351721 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 751646002 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 144 SEC ACT: 1933 Act SEC FILE NUMBER: 000-10521 FILM NUMBER: 04532540 BUSINESS ADDRESS: STREET 1: 6501 WINDCREST DRIVE SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 BUSINESS PHONE: 9723098000 MAIL ADDRESS: STREET 1: 6501 WINDCREST DRIVE SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 FORMER COMPANY: FORMER CONFORMED NAME: QUEST MEDICAL INC DATE OF NAME CHANGE: 19920703 144 1 hawari144_012004.txt FORM 144 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 OMB APPROVAL ------------------------------- FORM 144 OMB Number: 3235-0101 Expires: December 31, 2003 Estimated average burden hours per response.......2.0 NOTICE OF PROPOSED SALE OF SECURITIES ------------------------------- PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933 SEC USE ONLY --------------------- DCOUMENT SEQUENCE NO. --------------------- CUSIP NUMBER --------------------- WORK LOCATION ATTENTION: Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute sale or executing a sale directly with a market maker. - ------------------------------------------------------------------------------- 1. (a) NAME OF ISSUER (Please type or print) (b) IRS IDENT. NO. Advanced Neuromodulation Systems, Inc. 75-1646002 - ------------------------------------------------------------------------------- (c) S.E.C. FILE NO. 0-10521 - ------------------------------------------------------------------------------- (d) ADDRESS OF ISSUER STREET CITY STATE ZIP CODE 6501 Windcrest Drive Plano Texas 75024 - ------------------------------------------------------------------------------- (e) TELEPHONE AREA CODE NUMBERS 972-309-8000 - ------------------------------------------------------------------------------- 2. (a) NAME OF PERSON FOR WHOSE ACCOUNT THE SECURITIES ARE TO BE SOLD Kenneth G. Hawari - ------------------------------------------------------------------------------- (b) IRS IDENT. NO. (c) RELATIONSHIP TO ISSUER ###-##-#### General Counsel; Executive Vice President- Corporate Development; and Secretary - ------------------------------------------------------------------------------- (d) ADDRESS STREET CITY STATE ZIP CODE 3605 Edgestone Plano Texas 75093 - ------------------------------------------------------------------------------- INSTRUCTION: The person filing this notice should contact the issuer to obtain the I.R.S. Identification Number and the S.E.C. File Number. - ------------------------------------------------------------------------------- 3. (a) TITLE OF THE CLASS OF SECURITIES TO BE SOLD Common Stock, $0.05 Par Value - ------------------------------------------------------------------------------- (b) NAME AND ADDRESS OF EACH BROKER TRHOUGH WHOM THE SECURITIES ARE TO BE OFFERED OR EACH MARKET MAKER WHO IS ACQUIRING THE SECURITIES Morgan Keegan & Co., Inc. 5956 Sherry Lane, Suite 1900, Dallas, Texas 75225 - ------------------------------------------------------------------------------- SEC USE ONLY BROKER-DEALER FILE NUMBER - ------------------------------------------------------------------------------- (c) NUMBER OF SHARES OR OTHER UNITS (d) AGGREGATE MARKET TO BE SOLD VALUE (See Instr. 3(c)) (See Instr. 3(d)) 17,500 $804,650.00 - ------------------------------------------------------------------------------- (e) NUMBER OF SHARES OR OTHER UNITS (f) APPROXIMATE DATE OF SALE OUTSTANDING (See Instr. 3(f)) (See Instr. 3(e)) (MO.DAY YR.) 19,846,374 01/20/04 - ------------------------------------------------------------------------------- (g) NAME OF EACH SECURITIES EXCHANGE (See Instr. 3(g)) NASDAQ - ------------------------------------------------------------------------------- INSTRUCTIONS: 1. (a) Name of issuer (b) Issuer's I.R.S. Identification Number (c) Issuer's S.E.C. file (d) Issuer's address, including zip code (e) Issuers's telephone number, including area code 2. (a) Name of person for whose acount the securities are to be sold (b) Such person's I.R.S. identification number, if such person is an entity (c) Such person's relationship to the issuer (e.g., officer, director, 10% stockholder, or member of immediate family of any of the foregoing) (d) Such person's address, including zip code 3. (a) Title of the class of securities to be sold (b) Name and address of each broker through whom the securities are intended to be sold (c) Number of shares or other units to be sold (if debt securities, give the aggregate face amount) (d) Aggregate market value of the securities to be sold as of a specified date within 10 days prior to the filing of this notice (e) Number of shares or other units of the class outstanding, or if debt securities the face amount thereof outstanding, as shown by the most recent report or statement published by the issuer (f) Approximate date on which the securities are to be sold (g) Name of each securities exchange, if any, on which the securities are intended to be sold TABLE I -- SECURITIES TO BE SOLD Furnish the following information with respect to the acquisition of the securities to be sold and with respect to the payment of all or any part of the purchase price or other consideration therefor: - ------------------------------------------------------------------------------- TITLE OF DATE YOU NATURE OF THE CLASS ACQUIRED ACQUISITION TRANSACTION Common Stock 01/20/04 Stock Option Exercise $0.05 Par Value - ------------------------------------------------------------------------------- NAME OF PERSON FROM WHOM ACQUIRED AMOUNT OF SECURITIES (If gift, also give date donor acquired) ACQUIRED ANSI 17,500 - ------------------------------------------------------------------------------- DATE OF PAYMENT NATURE OF PAYMENT 01/20/04 Cash - ------------------------------------------------------------------------------- INSTRUCTIONS: 1. If the securities were purchased 2. If within two years after the and full payment therefore was not acquisition of the securities the made in cash at the time of purchase, person for whose account they are explain in the table or in a note to be sold had any short positions, thereto the nature of the considera- put or other option to dispose of ation given. If the consideration securities referred to in para- consisted of any note or other graph (d)(3) of Rule 144, furnish obligation, or if payment was made full information with respect in installmetns describe the arrange- thereto. ment and state when the note or other obligation was discharged in full or the last installment paid. - ------------------------------------------------------------------------------- TABLE II -- SECURITIES SOLD DURING THE PAST 3 MONTHS Furnish the following information as to all securities of the issuer sold during the past 3 months by the person for whose account the securities are to be sold - ------------------------------------------------------------------------------- NAME AND ADDRESS OF SELLER - ------------------------------------------------------------------------------- TITLE OF SECURITIES SOLD DATE OF SALE - ------------------------------------------------------------------------------- AMOUNT OF SECURITIES SOLD GROSS PROCEEDS - ------------------------------------------------------------------------------- REMARKS: INSTRUCTIONS: See the definition of "person" in paragraph (a) of Rule 144. Information is to be be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice. January 20, 2004 -------------------------- DATE OF NOTICE ATTENTION: The person for whose account the securities to which this notice relates are to sold hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publicly disclosed. Kenneth G. Hawari BY: /s/Linda Moses, by Power of Attorney - -------------------------------------------------------------------- (SIGNATURE) The notice shall be signed by the person for whose account the securities are to be sold. At least one copy of the notice shall be manually signed. Any copies not manually signed shall bear typed or printed signatures. - ------------------------------------------------------------------------------- ATTENTION: Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001) - ------------------------------------------------------------------------------- -----END PRIVACY-ENHANCED MESSAGE-----