-----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, JSoKtvE5u4NM6xPoFGonn2Cbr0uywUC7qtZufo0hht7LUPziAtcU2KuafzebimL0 b1TL/Jww6cYlQpkojVDCFg== 0001014108-99-000027.txt : 19990212 0001014108-99-000027.hdr.sgml : 19990212 ACCESSION NUMBER: 0001014108-99-000027 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981231 FILED AS OF DATE: 19990211 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LABONE INC CENTRAL INDEX KEY: 0000816151 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 480952323 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-15975 FILM NUMBER: 99532161 BUSINESS ADDRESS: STREET 1: 10310 W 84TH TERR CITY: LENEXA STATE: KS ZIP: 66214 BUSINESS PHONE: 9138888397 MAIL ADDRESS: STREET 1: 10310 W 84TH TERRACE CITY: LENEXA STATE: KS ZIP: 66214 FORMER COMPANY: FORMER CONFORMED NAME: HOME OFFICE REFERENCE LABORATORY INC DATE OF NAME CHANGE: 19940405 COMPANY DATA: COMPANY CONFORMED NAME: BREWER JOSEPH H CENTRAL INDEX KEY: 0001036348 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O LABONE INC STREET 2: 10310 W 84TH TERRACE PO BOX 2035 CITY: LENEXA STATE: KS ZIP: 66214 MAIL ADDRESS: STREET 1: LABONE INC STREET 2: 10310 W 84TH TERRACE PO BOX 2035 CITY: LENEA STATE: KS ZIP: 66214 5 1 ANNUAL STATEMENT CHANGES IN BENEFICIAL OWNERSHIP U. S. SECURITIE AND EXCHANGE COMMISSION [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. Washington, D.C. 20549 See instruction 1(b). [ ] Form 3 Holdings Reported. ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Form 4 Transactions Reported. Filed pursuant to Section 16(a)of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and 2. Issuer Name and Ticker or Trading 6. Relationship of Reporting Address of Symbol Person to Reporting Issuer (Check all applicable) Person* LabOne, Inc. - LABS Brewer, Joseph H. - -------------------------------------------------------- X Director __ 10% Owner (Last)(First)(Middle) 3. IRS or Social 4. Statement for __ Officer __ Other Security Month/Year (give title (specify below) Number of Reporting 12/31/98 below) 10338 Alhambra Person (Voluntary) - --------------------- ---------------------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Date of Filing Original (Check applicable line) Month/Year X Form filed by One Reporting Overland Park, KS 66207 Person __ Form filed by More than One Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City)(State) (Zip) Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned. - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2.Transaction 3.Transaction 4.Securities 5.Amount of 6.Ownership 7.Nature of Security Date: Code: Acquired (A) Securities Form: Indirect or Disposed of (D) Beneficially Direct Beneficial (Month/Day/ (Instr. 3, 4 and 5) Owned at End (D) or Ownership --------------------- Amount (A) or Price (D) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 6/1/98 A 556 A 5,195 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ * If the Form is filed by more than one Reporting Person, see instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1.Title 2.Conversion 3.Transaction 4.Trans- 5.Number 6.Date 7.Title and 8.Price of 9.Number 10.Ownership 11.Nature of or Exercise Date (Month/ action Deriv- Exer- Amount of Deriative of Deriv- Form of of In- Deriv- Price of Day/Year) Code ative cisable Underlying Security ative Derivative direct ative Derivative (Instr. Securities and Securiites (Instr.5) Securities Security; Bene- Security Security 8) Acquired Expir- (Instr. 3 Beneficially Direct (D) ficial (A) or ation and 4) Owned at End or Indirect Owner- Disposed of Date of Month (I) (Instr. ship (D) (Instr. (Month/ (Instr. 4) 4) (Instr. 3,4, and 5) Day/ 4) Year) ----------------------------------- (A) (D) Date Ex- Title Amount Exer- pir- or Num- cis- ation ber of able Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ Dr. Stock 9.875 1/2/91 1/2/95 1/2/ Common 20,052 Option 2001 Stock - ------------------------------------------------------------------------------------------------------------------------------------ Dr. Stock 11.125 3/1/91 3/1/96 3/1/ Common 1,948 22,000 D Option 2001 Stock - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: /s/ Joseph H. Brewer February 11,1999 ---------------------------------------- -------------------------- **Joseph H. Brewer by Randy Shelton Date as attorney-in-fact ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure.
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