0001159917-01-500002.txt : 20011010 0001159917-01-500002.hdr.sgml : 20011010 ACCESSION NUMBER: 0001159917-01-500002 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010930 FILED AS OF DATE: 20011005 COMPANY DATA: COMPANY CONFORMED NAME: LEVINE JOSHUA CENTRAL INDEX KEY: 0001159917 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 201 MENTOR DRIVE CITY: SANTA BARBARA STATE: CA ZIP: 91311 BUSINESS PHONE: 8058796000 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: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-07955 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 3 1 form3levine.htm FORM 3


Form 3

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

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

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(Print or Type Responses)

  

1.  Name and Address of Reporting Person*
Adel Michael
Mentor Corporation
201 Mentor Drive
Santa Barbara, CA 93111

2.  Date of Event Requiring Statement
  (Month/Day/Year)

September 14, 2001

4.  Issuer Name and Tickler or Trading Symbol

Mentor Corporation "MNTR"

(Last)         (First)         (Middle)

Levine, Joshua

(Street)

201 Mentor Drive

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

###-##-####

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

__ Director                              __ 10% Owner

_x_ Officer (give title below)     __ Other (specify below)

Vice President, Sales & Marketing, Aesthetic Products

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

N/A

(City)       (State)         (Zip)

Santa Barbara, CA 93111

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

_X_ Form filed by One Reporting Person

__ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned

1.Title of Security 
   (Instr. 4)

2.  Amount of Securities Beneficially Owned 
     (Instr. 4)

3.  Ownership Form: Direct (D) or  Indirect (I)
     (Instr. 5)

4.  Nature of Indirect Beneficial Ownership
     (Instr. 5)

  Common Stock 9,471 Direct/Indirect IRA

 

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security
    (Instr. 4)

2. Date Exercisable and Expiration Date
  (Month/Day/Year)

3. Title and Amount of Securities Underlying Derivative Security
    (Instr. 4)

4.  Conversion or Exercise Price of Derivative Security

5.  Ownership  Form of Derivative Securities: Direct  (D) or Indirect (I)
   (Instr. 5)

6.  Nature of Indirect Beneficial Ownership
     (Instr. 5)

Date Exercisable

Expiration Date

  Title  

Amount or Number of Shares
  Common Stock Options 9/19/01 9/19/10   Common Stock   25,000   19.69   Direct N/A
   5/23/01 5/23/10 Common Stock 30,000 26.61 Direct N/A

 

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

Explanation of Responses:  

 

         

   /S/Adel Michael   
**Signature of Reporting Person
By:  Adel Michael, Attorney-In-Fact

     October 5, 2001  
Date

*

If the form is filed by more than one reporting person, see Instruction 5(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.