0001209191-15-013637.txt : 20150213 0001209191-15-013637.hdr.sgml : 20150213 20150213165434 ACCESSION NUMBER: 0001209191-15-013637 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141231 FILED AS OF DATE: 20150213 DATE AS OF CHANGE: 20150213 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: MOORE DAN T III CENTRAL INDEX KEY: 0001207229 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-15103 FILM NUMBER: 15615792 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2014-12-31 0 0 0 0000742112 INVACARE CORP IVC 0001207229 MOORE DAN T III ONE INVACARE WAY ELYRIA OH 44035 1 0 0 0 Common Shares 7171 D Common Shares 104917 I By Trust Common Shares 1082 I By IRA Stock Option (Right to Buy) Common Shares 18569 18569 D These shares are held by a local bank as custodian for an IRA. Due to a bookeeping error these shares were inadvertantly omitted from the reporting person's prior reports and is not reflective of any acquisition or sale. 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 18,569 Common Shares (with tandem tax withholding rights) under the Invacare Corporation 2003 Performance Plan, granted in reliance upon the exemption provided by Rule 16b-3. All options were granted between March 2, 2005 and August 20, 2008, at exercise prices between $23.71 and $47.01 per share, will expire between March 2, 2015 and August 20, 2018, and became exercisable between December 21, 2005 and September 30, 2012. The current balance reflects the expiration of 2,000 options on March 11, 2014. /s/ Dan T. Moore III, by Kristofer K. Spreen, his attorney-in-fact pursuant to Power of Attorney, dated February 12, 2009, on file with the Commission 2015-02-13