-----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, Oxs18w+JilpezSUt2Nfv5bYpf55Bmk381oK/FscyZuKkGYmhPT/Icb0aUslJKFLq 3ltKIelmzT1ioBoQ8hko4g== 0001187451-03-000003.txt : 20030915 0001187451-03-000003.hdr.sgml : 20030915 20030915150404 ACCESSION NUMBER: 0001187451-03-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030911 FILED AS OF DATE: 20030915 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MEDTOX SCIENTIFIC INC CENTRAL INDEX KEY: 0000739944 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 953863205 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 402 WEST COUNTY ROAD D CITY: ST PAUL STATE: MN ZIP: 55112 BUSINESS PHONE: 6126367466 MAIL ADDRESS: STREET 1: 402 WEST COUNTY ROAD D CITY: ST PAUL STATE: MN ZIP: 55112 FORMER COMPANY: FORMER CONFORMED NAME: EDITEK INC DATE OF NAME CHANGE: 19940902 FORMER COMPANY: FORMER CONFORMED NAME: ENVIRONMENTAL DIAGNOSTICS INC DATE OF NAME CHANGE: 19920703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WIERSMA KEVIN J CENTRAL INDEX KEY: 0001187451 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11394 FILM NUMBER: 03895580 BUSINESS ADDRESS: STREET 1: 402 WEST COUNTY ROAD D CITY: ST. PAUL STATE: MN ZIP: 55112 BUSINESS PHONE: 651-636-7466 MAIL ADDRESS: STREET 1: 402 WEST COUNTY RD D CITY: ST PAUL STATE: MN ZIP: 55112 4 1 form4wiersma091103_ex.xml FORM 4 X0201 4 2003-09-11 0 0000739944 MEDTOX SCIENTIFIC INC TOX 0001187451 WIERSMA KEVIN J 402 WEST COUNTY RD D ST PAUL MN 55112 0 1 0 0 Vice President and COO Restricted Stock 2003-09-11 4 A 0 6306 0 A 28418 D Non-Qualified Stock Option (right to buy) 5.55 2003-09-11 4 A 0 20000 5.55 A 2003-09-11 2013-12-31 Common Stock 20000 20000 D 4,538 shares vest on 11/1/03, 7,260 shares vest on 5/1/04, 2,750 shares vest on 1/1/05, 5,295 shares vest on 1/2/06, 2,269 shares vest on 1/2/06, 6,306 shares vest on 12/31/06 Kevin J. Wiersma 2003-09-15 -----END PRIVACY-ENHANCED MESSAGE-----