0001209191-12-009077.txt : 20120210 0001209191-12-009077.hdr.sgml : 20120210 20120210163744 ACCESSION NUMBER: 0001209191-12-009077 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111231 FILED AS OF DATE: 20120210 DATE AS OF CHANGE: 20120210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOORE DAN T III CENTRAL INDEX KEY: 0001207229 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 12593476 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 5 1 doc5.xml FORM 5 SUBMISSION X0304 5 2011-12-31 0 0 0 0000742112 INVACARE CORP IVC 0001207229 MOORE DAN T III ONE INVACARE WAY ELYRIA OH 44035 1 0 0 0 Common Shares 65186 D Common Shares 37532 I By Trust Stock Option (Right to Buy) Common Shares 28142 28142 D Held by local bank as Trustee for IRA Trust. 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 28,142 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 January 31, 2002 and August 20, 2008, at exercise prices between $23.71 to $47.01 per share, will expire between January 31, 2012 and August 20, 2018, and became or will become exercisable between March 31, 2003 and September 30, 2012. The current balance reflects the expiration of 2,185 options on November 13, 2011. /s/ Dan T. Moore III 2012-02-09