0001144204-16-125321.txt : 20160926 0001144204-16-125321.hdr.sgml : 20160926 20160926161555 ACCESSION NUMBER: 0001144204-16-125321 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160926 DATE AS OF CHANGE: 20160926 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INVACARE CORP CENTRAL INDEX KEY: 0000742112 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 952680965 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE INVACARE WAY STREET 2: P O BOX 4028 CITY: ELYRIA STATE: OH ZIP: 44036 BUSINESS PHONE: 4403296000 MAIL ADDRESS: STREET 1: ONE INVACARE WAY STREET 2: P O BOX 4028 CITY: ELYRIA STATE: OH ZIP: 44036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MIXON AARON MALACHI III CENTRAL INDEX KEY: 0000937770 FILING VALUES: FORM TYPE: 5/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 161902420 MAIL ADDRESS: STREET 1: 800 SUPERIOR AVENUE STREET 2: SUITE 1800 CITY: CLEVELAND STATE: OH ZIP: 44107 5/A 1 v449354_5-a.xml OWNERSHIP DOCUMENT X0306 5/A 2015-12-31 2016-01-29 1 0 0 0000742112 INVACARE CORP IVC 0000937770 MIXON AARON MALACHI III 31100 PINETREE ROAD, #208 PEPPER PIKE OH 44124 0 0 0 1 Retired as Dir. 6/30/2015 Common Shares 2015-12-29 5 G 0 2232 D 104879 D Common Shares 158530 I Through A. Malachi Mixon III Trust Common Shares 19045 I By IRA Common Shares 4106 I By Family Foundation The original Form 5 filed on January 29, 2016 is amended by this Form 5/A to correctly reflect the amount of securities beneficially owned. No other changes have been made to this line The original Form 5 filed on January 29, 2016 is amended by this Form 5/A to correctly reflect the amount of securities beneficially owned. No other changes have been made to this line. No transaction is being reported on this line. The original Form 5 filed on January 29, 2016 is amended by this Form 5/A to add this line in order to show Class B Common Shares the reporting person holds through his IRA. The original Form 5 filed on January 29, 2016 is amended by this Form 5/A to add this line in order to show Class B Common Shares the reporting person holds through his Family Foundation. /s/A. Malachi Mixon, by Molly Z. Brown, his attorney-in-fact, pursuant to Power of Attorney, dated 1/12/2016, on file with the Commission 2016-09-26