0001209191-12-053765.txt : 20121119 0001209191-12-053765.hdr.sgml : 20121119 20121119161407 ACCESSION NUMBER: 0001209191-12-053765 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121115 FILED AS OF DATE: 20121119 DATE AS OF CHANGE: 20121119 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: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 121214741 MAIL ADDRESS: STREET 1: ONE INVACARE WAY CITY: ELYNA STATE: OH ZIP: 440362125 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-11-15 0 0000742112 INVACARE CORP IVC 0001225248 BLOUCH GERALD B ONE INVACARE WAY ELYRIA OH 44035 1 1 0 0 President and CEO Common Shares 2012-11-15 4 F 0 5616 13.02 D 216232 D Common Shares 22083.693 I By Invacare Retirement Savings Plan Employee Stock Option (Right to Buy) Common Shares 599600 599600 D The surrender of these shares is for tax withholding purposes in conjunction with the vesting of restricted shares held by the reporting person. 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 599,600 Common Shares (with tandem tax withholding rights) the Invacare Corporation 2003 Performance Plan, granted in reliance upon the exemption provided by Rule 16b-3. All options were granted between August 20, 2003 and August 14, 2012, at exercise prices between $13.37 to $44.30 per share, will expire between August 20, 2013 and August 14, 2022 and became or will become exercisable between September 30, 2004 and September 30, 2016. The current balance reflects the expiration of 55,000 options on August 21, 2012. /s/ Gerald B. Blouch, by Kristofer K. Spreen, his attorney-in-fact pursuant to Power of Attorney, dated February 12, 2009, on file with the Commission. 2012-11-19