-----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, B5w4tO9cV5WvseXqvSIG1mLRSZlanMZfGsUz3QYC9kxIke3SeiJW3nrV26LpfkZJ vekU9Z/lMxSbZjMWJTch3g== 0000950148-03-000125.txt : 20030130 0000950148-03-000125.hdr.sgml : 20030130 20030130151831 ACCESSION NUMBER: 0000950148-03-000125 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020831 FILED AS OF DATE: 20030130 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CHAD THERAPEUTICS INC CENTRAL INDEX KEY: 0000713492 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 953792700 STATE OF INCORPORATION: CA FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12214 FILM NUMBER: 03531942 BUSINESS ADDRESS: STREET 1: 21622 PLUMMER STREET CITY: CHATSWORTH STATE: CA ZIP: 91311 BUSINESS PHONE: 8188820883 MAIL ADDRESS: STREET 1: 21622 PLUMMER STREET CITY: CHATSWORTH STATE: CA ZIP: 91311 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: LASKEY ERIKA CENTRAL INDEX KEY: 0001208106 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 21622 PLUMMER STREET CITY: CHATTSWORTH STATE: CA ZIP: 91311 BUSINESS PHONE: 8188820883 MAIL ADDRESS: STREET 1: 21622 PLUMMER STREET CITY: CHATSWORTH STATE: CA ZIP: 91311 5 1 v87264f5e5.htm 5 Form 5
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM 5

ANNUAL 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(h) of the Investment Company Act of 1940

o Check box if no longer
subject to Section 16.
Form 4 or Form 5
obligations may continue.
See Instruction 1(b).
o Form 3 Holdings Reported
o Form 4 Transactions Reported

1. Name and Address of Reporting
Person*
2. Issuer Name and Ticker or Trading
Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Laskey, Erika
(Last) (First) (Middle)
  Chad Therapeutics, Inc. - CTU
 
   
                 
  25411 Picador Lane
4. Statement for Month/Year 5. If Amendment, Date of Original (Month/Year)
    December, 2002
 
  (Street) 6. Relationship of Reporting Person(s)
to Issuer
(Check All Applicable)
7. Individual or Joint/Group Reporting
(Check Applicable Line)
  Mission Viejo, CA 92691
(City)        (State)        (Zip)
  o  Director o  10% Owner   þ Form filed by One Reporting Person
    þ  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)  
      V. P. Sales and Marketing
     

*   If the form is filed by more than one reporting person, see instruction 4(b)(v).


 

                                                 

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

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
at the End of Issuer's
Fiscal Year

(Instr. 3 and 4)
6. Ownership
Form:
Direct (D) or
Indirect (I)

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

(Instr. 4)

                    Amount (A)
or
(D)
Price            

  Common Shares   8/31/02     I   499   A 2.83         I   Retirement Plan

  Common Shares   9/30/02     I   579   A 2.44         I   Retirement Plan

  Common Shares   10/31/02     I   1309   A 2.44         I   Retirement Plan

  Common Shares   11/30/02     I   530   A 2.66         I   Retirement Plan

  Common Shares   12/31/02     I   437   A 1.94     6373     I   Retirement Plan

                     

                     

Page 2


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
  (e.g., puts, calls, warrants, options, convertible securities)

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)

                            (A) (D)

  Option     2.74     12/03/02     A   A

               

               

               

               

               

               

               

               

Page 3


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount of
Underlying Securities

(Instr. 3 and 4)
8. Price of Derivative
Security

(Instr. 5)
9. Number of Derivative
Securities Beneficially
Owned at End of
Year

(Instr. 4)
10. Ownership of
Derivative Security:
Direct (D)
or Indirect (I)

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

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

  12/3/03 12/3/13   Common shares 15000     0       40000     D  

                   

                   

                   

                   

                   

                   

                   

                   

Explanation of Responses:

/s/ Erika Laskey   1/30/03

**Signature of Reporting Person
 
Date


**   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.

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