-----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, D+qV7JdpE1jtvsxCELH/SFVjaEjqa6DwxE61qhcdYFgC4X7mkiBmmZKJGZD69rNR pFLGtkTA5Zr+05000hfoAQ== 0001209191-11-008799.txt : 20110211 0001209191-11-008799.hdr.sgml : 20110211 20110211152953 ACCESSION NUMBER: 0001209191-11-008799 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101231 FILED AS OF DATE: 20110211 DATE AS OF CHANGE: 20110211 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: 11598619 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 X0303 5 2010-12-31 0 0 0 0000742112 INVACARE CORP IVC 0001233925 SLANGEN LOUIS F J ONE INVACARE WAY ELYRIA OH 44035 0 1 0 0 Senior Vice President Common Shares 29067 D Common Shares 10249.591 I By Invacare Retirement Savings Plan Common Shares 520 I By Spouse Employee Stock Option (Right to Buy) Common Shares 170200 170200 D Owned by the Trustee for the Invacare Retirement Savings Plan. The information given is based on a Plan Statement of December 31, 2010, 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 170,200 Common Shares (with tandem tax withholding rights) under the Invacare Corporation 1994 Performance Plan and the Invacare Corporation 2003 Performance Plan, granted in reliance upon the exemption provided by Rule 16b-3. All options were granted between October 31, 2001 and August 18, 2010, at exercise prices between $20.48 to $44.30 per share, will expire between October 31, 2011 and August 18, 2020 and became or will become exercisable between September 30, 2002 and September 30, 2014. /s/ Louis F. J. Slangen, by Kristofer K. Spreen, his attorney-in-fact pursuant to Power of Attorney, dated February 12, 2009, on file with the Commission 2011-02-11 -----END PRIVACY-ENHANCED MESSAGE-----