-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, U6evLKB1mf2wzJg2HQD57MDNrdXEYusxFcUpxFAIezeaL9p1jOw83afRkMEECNvd MOZDY7DblWJP3g37expytQ== 0000779152-04-000047.txt : 20040803 0000779152-04-000047.hdr.sgml : 20040803 20040803095306 ACCESSION NUMBER: 0000779152-04-000047 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040730 FILED AS OF DATE: 20040803 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ELLIS JAMES J CENTRAL INDEX KEY: 0001192954 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-14112 FILM NUMBER: 04946806 BUSINESS ADDRESS: STREET 1: C/O MERIT MEDICAL SYSTEMS INC STREET 2: 1600 W MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HENRY JACK & ASSOCIATES INC CENTRAL INDEX KEY: 0000779152 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 431128385 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: PO BOX 807 STREET 2: 663 HWY 60 CITY: MONETT STATE: MO ZIP: 65708-0807 BUSINESS PHONE: 4172356652 MAIL ADDRESS: STREET 1: PO BOX 807 STREET 2: 663 HWY 60 CITY: MONETT STATE: MO ZIP: 65708-0807 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-07-30 0 0000779152 HENRY JACK & ASSOCIATES INC JKHY 0001192954 ELLIS JAMES J 1 0 0 0 Common Stock 2004-07-30 4 S 0 5700 19.4104 D 334300 D Non-Qualified Stock Option (right to buy) 6.4063 1998-05-04 2007-11-04 Common Stock 30000 30000 D Non-Qualified Stock Option (right to buy) 6.75 1997-05-01 2006-11-01 Common Stock 30000 30000 D Non-Qualified Stock Option (right to buy) 9.1563 2000-05-03 2009-11-03 Common Stock 30000 30000 D Non-Qualified Stock Option (right to buy) 10.869 2003-05-01 2012-11-01 Common Stock 10000 10000 D Non-Qualified Stock Option (right to buy) 11.9531 1999-05-03 2008-11-03 Common Stock 30000 30000 D Non-Qualified Stock Option (right to buy) 19.83 2004-04-30 2013-10-31 Common Stock 10000 10000 D Non-Qualified Stock Option (right to buy) 25.65 2002-05-05 2011-11-05 Common Stock 30000 30000 D Non-Qualified Stock Option (right to buy) 28.25 2001-05-03 2010-11-03 Common Stock 30000 30000 D JAMES J. ELLIS 2004-08-02 -----END PRIVACY-ENHANCED MESSAGE-----