0001209191-12-009038.txt : 20120210
0001209191-12-009038.hdr.sgml : 20120210
20120210162955
ACCESSION NUMBER: 0001209191-12-009038
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120210
DATE AS OF CHANGE: 20120210
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: BLOUCH GERALD B
CENTRAL INDEX KEY: 0001225248
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-15103
FILM NUMBER: 12593314
MAIL ADDRESS:
STREET 1: ONE INVACARE WAY
CITY: ELYNA
STATE: OH
ZIP: 440362125
5
1
doc5.xml
FORM 5 SUBMISSION
X0304
5
2011-12-31
0
0
0
0000742112
INVACARE CORP
IVC
0001225248
BLOUCH GERALD B
ONE INVACARE WAY
ELYRIA
OH
44035
1
1
0
0
President and CEO
Common Shares
195448
D
Common Shares
22083.693
I
By Invacare Retirement Savings Plan
Employee Stock Option (Right to Buy)
Common Shares
529600
529600
D
Owned by the Trustee for the Invacare Retirement Savings Plan. The information given is based on a Plan Statement of December 31, 2011, 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 529,600 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 August 21, 2002 and September 2, 2011, at exercise prices between $20.48 to $44.30 per share, will expire between August 21, 2012 and September 2, 2021 and became or will become exercisable between September 30, 2003 and September 30, 2015.
/s/Gerald B. Blouch
2012-02-06