| FORM 4 |
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 or Section 30(h) of the Investment Company Act of 1940 |
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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
BIO LOGIC SYSTEMS CORP [ BLSC ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/04/2004 | ||||||||||||||||||||||||||
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4. If Amendment, Date of Original Filed
(Month/Day/Year) 01/13/2005 |
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 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 Following Reported Transaction(s) (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 | ||||||
| Common Stock, $0.01 par value | 12/17/2004 | G(2) | 3,939(1) | D | $0 | 199,606(1) | D(3) | |||
| Common Stock, $0.01 par value | 01/11/2005 | M | 2,500(1) | A | $5.13(1) | 202,106(1) | D(3) | |||
| Common Stock, $0.01 par value | 01/11/2005 | M | 1,875(1) | A | $5.58(1) | 203,981(1) | D(3) | |||
| Common Stock, $0.01 par value | 01/11/2005 | M | 26,250(1) | A | $4.95(1) | 230,231(1) | D(3) | |||
| Common Stock, $0.01 par value | 01/11/2005 | F | 15,926(1) | D | $9.62(1) | 214,305(1) | D(3) | |||
| Common Stock, $0.01 par value | 11/04/2004 | G(4) | 193,000(1) | A | $0 | 193,000(1) | I | See Note(5)(6) | ||
| Common Stock, $0.01 par value | 12/17/2004 | G(2) | 3,939(1) | A | $0 | 196,939(1) | I | See Note(5) | ||
| Common Stock, $0.01 par value | 210,125(1) | D(7) | ||||||||
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction 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 Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (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 (Right to Buy) | $5.13 | 01/11/2005 | M | 2,500(1) | 08/17/2004 | 08/17/2005 | Common Stock | 2,500(1) | $0 | 0 | D(3) | ||||
| Stock Option (Right to Buy) | $5.58 | 01/11/2005 | M | 1,875(1) | 08/23/2004(8) | 08/23/2006 | Common Stock | 1,875(1) | $0 | 625(1) | D(3) | ||||
| Stock Option (Right to Buy) | $4.95 | 01/11/2005 | M | 26,250(1) | 06/05/2004(8) | 06/05/2006 | Common Stock | 26,250(1) | $0 | 8,750(1) | D(3) | ||||
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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| Explanation of Responses: |
| 1. None of the share and exercise proce data contained in thie Form 4/A has been adjusted to reflect the 3-for-2 stock split of the Common Stock effected as a 50 percent stock dividend on February 11, 2005 to stockholders of record as of January 26, 2005. |
| 2. Transfer of shares from Gabriel Raviv to the Raviv Family Limited Partnership, of which Gabriel Raviv and his spouse, Dorit Raviv, are the sole general partners, and of which their three children are the sole limited partenrs. |
| 3. These securities are owned directly by Gabriel Raviv. |
| 4. Transfer of shares from the Gabriel Raviv Family Trust to the Raviv Family Limited Partnership. |
| 5. These shares are held by tghe Raviv Family Limited Parthnership. Gabriel Raviv and Dorit Raviv disclaim beneficial ownershuip of the shares of Common Stock held by the Raviv Family Limited Partnership except to the extent of their pecuniary interest therein. This Form 4/A does not include 30,000 shares previously reported by Gabriel Raviv as Trustee for the Gil Raviv Family Trust because Gabriel Raviv never had a pecuniary interes in such shares. |
| 6. This transaction gave rise to Dorit Raviv's obligation to file reports under Section 16(a) of the Securities Exchange Act of 1934, as amended, and as such , is not a reportable transaction for her. |
| 7. These shares are owned directly by Dorit Raviv. |
| 8. Shares vest 25% per year over the first four years from the option grant date. The date shown represents the most recent vesting date associated with the options being exercised. |
| /s/ Michael J. Hanley as Attorney-In-Fact | 02/18/2005 | |
| ** Signature of Reporting Person | 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. | ||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. | ||