-----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, UeraVMV9sUmtzWHunGdxEAqiZ3oaLZRBwMHC7levdjZZd6tdu3c31peNZToAbVHS gf4FZCdGwVihaVpRDuh/5w== 0001129787-03-000023.txt : 20030130 0001129787-03-000023.hdr.sgml : 20030130 20030130165428 ACCESSION NUMBER: 0001129787-03-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030128 FILED AS OF DATE: 20030130 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MENTOR CORP /MN/ CENTRAL INDEX KEY: 0000064892 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 410950791 STATE OF INCORPORATION: MN FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-07955 FILM NUMBER: 03532465 BUSINESS ADDRESS: STREET 1: 201 MENTOR DR CITY: SANTA BARBARA STATE: CA ZIP: 93111 BUSINESS PHONE: 8058796000 MAIL ADDRESS: STREET 1: 201 MENTOR DR CITY: SANTA BARBARA STATE: CA ZIP: 93111 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: VA PARTNERS LLC CENTRAL INDEX KEY: 0001129787 RELATIONSHIP: OWNER IRS NUMBER: 943364923 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: ONE MARITIME PLAZA STREET 2: STE 1400 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 BUSINESS PHONE: 4153623700 MAIL ADDRESS: STREET 1: ONE MARITIME PLAZA STREET 2: STE 1400 CITY: SAN FRANCISCO STATE: CA ZIP: 94111 4 1 mntrform4013003.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 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 [_] Check 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* VA Partners, LLC - ------------------------------------------------------------------------------- (Last) (First) (Middle) One Maritime Plaza, Suite 1400 - ------------------------------------------------------------------------------- (Street) San Francisco CA 94111 - ------------------------------------------------------------------------------- (City) (State) (Zip) - ------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Mentor Corporation (MNTR) - ------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - ------------------------------------------------------------------------------- 4. Statement for Month/Day/Year JANUARY 28, 2003 - ------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Day/Year) - ------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) - ------------------------------------------------------------------------------- 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 Acquired, Disposed of, or Beneficially Owned =====================================================================
6. 4. 5. Owner- Securities Acquired (A) Amount of ship 3. or Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. 2A. Deemed Code ------------------------ Owned Following (D) or Indirect 1. Transaction Execution (Instr. 8) (A) Reported Transaction Indirect Beneficial Title of Security Date Date, if any ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - -------------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------------------- Common Stock 01/28/03 P 8,600 A 17.05 5,703,000(1)(2)(3) I (1)(2) - -------------------------------------------------------------------------------------------------------------------------------- Common Stock 01/30/03 P 22,000 A 17.11 5,725,000(1)(2)(3) I (1)(2) - -------------------------------------------------------------------------------------------------------------------------------- ================================================================================================================================
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). 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 control number. (Over) SEC 1474 (3-00) PAGE 2 OF 5 FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ==============================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative Following In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- Reported direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Transaction (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1)As General Partner and Investment Manager of ValueAct Capital Partners, L.P., ValueAct Capital Partners II, L.P., and ValueAct Capital International, Ltd. (2)These securities are also beneficially owned by Jeffrey W. Ubben, George F. Hamel, Jr., and Peter H. Kamin as Managing Members, Principal Owners and Controlling Persons of VA Partners, LLC. (3) Adjusted for 2-for-1 stock split effective January 21, 2003. VALUEACT CAPITAL PARTNERS, L.P., BY VA PARTNERS, L.L.C., ITS GENERAL PARTNER By: /s/ George F. Hamel, Jr. 01/30/03 ----------------------------------------- ---------------- George F. Hamel, Jr. Date Managing Member **Signature of Reporting Person VALUEACT CAPITAL PARTNERS II, L.P., BY VA PARTNERS, L.L.C., ITS GENERAL PARTNER By: /s/ George F. Hamel, Jr. 01/30/03 ----------------------------------------- ---------------- George F. Hamel, Jr. Date Managing Member **Signature of Reporting Person VALUEACT CAPITAL INTERNATIONAL, LTD., BY VA PARTNERS, L.L.C., ITS INVESTMENT MANAGER By: /s/ George F. Hamel, Jr. 01/30/03 ----------------------------------------- ---------------- George F. Hamel, Jr. Date Managing Member **Signature of Reporting Person PAGE 3 OF 5 VA PARTNERS, L.L.C. By: /s/ George F. Hamel, Jr. 01/30/03 ------------------------------------------ ---------------- George F. Hamel, Jr. Date Managing Member **Signature of Reporting Person By: /s/ Jeffrey W. Ubben 01/30/03 ----------------------------------------- ---------------- Jeffrey W. Ubben Date **Signature of Reporting Person By: /s/ George F. Hamel, Jr. 01/30/03 ------------------------------------------ ---------------- George F. Hamel, Jr. Date **Signature of Reporting Person By: /s/ Peter H. Kamin 01/30/03 - --------------------------------------------- ----------------- Peter H. Kamin Date **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 provided is insufficient, see Instruction 6 for procedure. PAGE 4 OF 5 Joint Filer Information Name: ValueAct Capital Partners, L.P. Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 Name: ValueAct Capital Partners II, L.P. Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 Name: ValueAct Capital International, Ltd. Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 Name: Jeffrey W. Ubben Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 Name: George F. Hamel, Jr. Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 Name: Peter H. Kamin Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111 Designated Filer: VA Partners, L.L.C. Issuer and Ticker Symbol: Mentor Corporation (MNTR) Date of Event Requiring Statement: January 28, 2003 PAGE 5 OF 5 -----END PRIVACY-ENHANCED MESSAGE-----