-----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, WlgTuAnWf50zDFFfmr/hRjVM69As9I930KzNmCVCFCD7i7rddXDcZSIcw0ySc4KV UvrZSF6dprGOkw8E4vkFew== 0001191966-02-000002.txt : 20020924 0001191966-02-000002.hdr.sgml : 20020924 20020924144610 ACCESSION NUMBER: 0001191966-02-000002 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020920 FILED AS OF DATE: 20020924 SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11394 FILM NUMBER: 02770986 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: ENVIRONMENTAL DIAGNOSTICS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: EDITEK INC DATE OF NAME CHANGE: 19940902 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: MARZEC ROBERT J CENTRAL INDEX KEY: 0001191966 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 36 PARK LN CITY: MINNEAPOLIS STATE: MN ZIP: 55416 BUSINESS PHONE: 6129274817 MAIL ADDRESS: STREET 1: 36 PARK LN CITY: MINNEAPOLIS STATE: MN ZIP: 55416 3 1 form3marzec092002.txt FORM 3 THIS DOCUMENT IS A COPY OF THE FORM 3 FILED ON SEPTEMBER 23, 2002 PURSUANT TO A RULE 201 TEMPORARY HARDSHIP EXEMPTION. UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person Marzec, Robert J 36 Park Lane Minneapolis, MN 55416 2. Date of Event Requiring Statement (Month/Day/Year) 9/20/2002 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Issuer Name and Ticker or Trading Symbol MEDTOX SCIENTIFIC, INC. (TOX) 5. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) Director 6. If Amendment, Date of Original (Month/Day/Year) 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 2)Amount of 3) 4)Nature of Securities D Indirect Beneficially or Beneficial Owned I Ownership - ----------------------------------------------------------------------------------------------------- Table II Derivative Securitites Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative Security 2)Date Exercisable 3)Title and Amount of 4)Conver- 5)Ownership 6)Nature of and Expiration Date Securities Underlying sion or Form of Indirect (Month/Day/Year) Derivative Security exercise Derivative Beneficial price of Security Ownership Date Expira- Amount or Deri- Direct(D) Exer- tion Number of vative or cisable Date Title Shares Security Indirect(I) - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option 09/20/02 09/20/12 Common Stock 5,000 $7.7500 D Direct (right to buy) (1) Explanation of Responses: (1) Options vest daily beginning on DATE EXERCISABLE and continue vesting over a 3 year period.
SIGNATURE OF REPORTING PERSON /S/ By: Richard J. Braun For: Robert J. Marzec DATE 09/23/02
-----END PRIVACY-ENHANCED MESSAGE-----