-----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, WtJfN7rakJymQcvoWfXW7pofikxnXZLdWI60GGkwyNBJz8VanS8QrNR54oKaPTkO EfeOMVQwxZZCpbLcCZX9Sw== 0001209191-04-009144.txt : 20040212 0001209191-04-009144.hdr.sgml : 20040212 20040212150121 ACCESSION NUMBER: 0001209191-04-009144 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040212 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SLANGEN LOUIS F J CENTRAL INDEX KEY: 0001233925 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 04590434 BUSINESS ADDRESS: STREET 1: ONE INVACARE WAY STREET 2: P O BOX 4028 CITY: ELYRIA STATE: OH ZIP: 44036 BUSINESS PHONE: 4403296000 5 1 doc5.xml FORM 5 SUBMISSION X0201 5 2003-12-31 0 0 0 0000742112 INVACARE CORP IVC 0001233925 SLANGEN LOUIS F J ONE INVACARE WAY ELYRIA OH 44036 0 1 0 0 Senior V.P.-Sales & Marketing Common Shares 18897.0000 D Common Shares 11830.0000 I By Invacare Retirement Savings Plan Common Shares 520.0000 I By Spouse Employee Stock Option (Right to Buy) Common Shares 181900.0000 181900.0000 D Owned by Trustee for the Invacare Retirement Savings Plan. The information given is based on a Plan Statement of December 31, 2003, the most recent information reasonably available. No transaction is being reported on this line. Reported on a previously filed Form 3, Form 4, or Form 5. The reporting person holds previously reported options to buy 181,900 Common Shares (with tandem tax withholding rights) under the Invacare Corporation 1994 Performance Plan and the Invacare Corporation 2003 Performance Plan, in reliance upon the exemption provided by Rule 16b-3. All options were granted between February 26, 1996 and August 20, 2003, at exercise prices between $18.6875 to $37.70 per share, will expire between February 26, 2006 and August 20, 2013 and became or will become exercisable between March 31, 1997 and September 30, 2007. /s/ Louis F.J. Slangen, by Douglas A. Neary, his attorney-in-fact pursuant to Power of Attorney dated November 12, 2002 on file with the Commission 2004-02-12 -----END PRIVACY-ENHANCED MESSAGE-----