-----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, NvZAossQaAEQtaMmHvdRA/MnAHYsog9ywz73YH258HiAG8Rb8MWq/Bw06YqRWxMC B0+tyM6qwDJTCe3h1lgH+A== 0001187451-05-000017.txt : 20050815 0001187451-05-000017.hdr.sgml : 20050815 20050815175143 ACCESSION NUMBER: 0001187451-05-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050812 FILED AS OF DATE: 20050815 DATE AS OF CHANGE: 20050815 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: 051028463 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 form4wiersma081205_ex.xml PRIMARY DOCUMENT X0202 4 2005-08-12 0 0000739944 MEDTOX SCIENTIFIC INC TOX 0001187451 WIERSMA KEVIN J 14730 OAK LANE WAYZATA MN 55391 0 1 0 0 V.P., COO - Labs, and CFO Common Stock 2005-08-12 4 A 0 667 7.4889 A 27162 D Shares are attributable to a performance based non-qualified deferred compensation plan investment with three year vesting and subject to a substantial risk of forfeiture. Shares have been acquired either in a private transaction or in the open market and are exempt under Rule 16b-3. Kevin J. Wiersma 2005-08-15 -----END PRIVACY-ENHANCED MESSAGE-----