0001209191-12-009078.txt : 20120210 0001209191-12-009078.hdr.sgml : 20120210 20120210163843 ACCESSION NUMBER: 0001209191-12-009078 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: RICHEY JOSEPH B II CENTRAL INDEX KEY: 0000937769 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 12593490 MAIL ADDRESS: STREET 1: 425 CORPORATE CIRCLE CITY: GOLDEN STATE: CO ZIP: 80401 5 1 doc5.xml FORM 5 SUBMISSION X0304 5 2011-12-31 0 0 0 0000742112 INVACARE CORP IVC 0000937769 RICHEY JOSEPH B II ONE INVACARE WAY ELYRIA OH 44035 1 1 0 0 Senior Vice President Common Shares 656598 D Class B Common Shares 360262 D Common Shares 9264.973 I By Invacare Retirement Savings Plan Common Shares 10134 I By Charitable Remainder Unitrust Class B Common Shares 16000 I IRA Employee Stock Option (Right to Buy) Common Shares 150500 150500 D Phantom Stock Common Shares 351.465 351.465 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 150,500 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. Upon cessation of employment in accordance with the terms and conditions of the Invacare Corporation Deferred Compensation Plus Plan. Owned by Trustee for the Invacare Corporation Deferred Compensation Plus Plan. The information given is based on a Plan Statement of December 31, 2011, the most recent information reasonably available. /s/ Joseph B. Richey II 2012-02-09