-----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, QRSLoIKTtFEBXtyFezy5d170vTDfrvWIVZ0XNfRKFORK1PMBfdmbYyXojI+odBse o1IGcdcRkVVTYP9Xtlp6Dg== 0000779152-04-000067.txt : 20040910 0000779152-04-000067.hdr.sgml : 20040910 20040910141506 ACCESSION NUMBER: 0000779152-04-000067 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040909 FILED AS OF DATE: 20040910 DATE AS OF CHANGE: 20040910 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: 041024831 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 2004-09-09 0 0000779152 HENRY JACK & ASSOCIATES INC JKHY 0001192954 ELLIS JAMES J 1 0 0 0 Common Stock 2004-09-09 4 S 0 30000 19.231 D 300000 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 2004-09-10 -----END PRIVACY-ENHANCED MESSAGE-----