5 1 form5_r-antin.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [_] Form 3 Holdings Reported [X] Form 4 Transactions Reported ________________________________________________________________________________ 1. Name and Address of Reporting Person* ANTIN ROBERT L. -------------------------------------------------------------------------------- (Last) (First) (Middle) C/O VCA ANTECH, INC. 12401 WEST OLYMPIC BOULEVARD -------------------------------------------------------------------------------- (Street) LOS ANGELES CA 90064 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol VCA ANTECH, INC. (NASDAQ: WOOF) ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year 12/18/02 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) CHAIRMAN, PRESIDENT AND CHIEF EXECUTIVE OFFICER ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [_] Form filed by more than one Reporting Person ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) Securities ship 2A. or Disposed of (D) Beneficially Form: 7. Deemed (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. Execution 3. ----------------------- of Issuer's (D) or Indirect 1. Transaction Date, if Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date any (Month/ Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Day/Year) (Instr.8) (D) and 4) (Instr.4) (Instr. 4) ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================
* 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) (Over) FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion 3A. Number of Title and Amount Secur- ative Nature or Deemed Derivative 6. of Underlying 8. ities Secur- of Exer- Execu- Securities Date Securities Price Bene- ity: In- cise 3. tion Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- Date, 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action if Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date any action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month (Month Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- /Day /Day (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity /Year) /Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ EMPLOYEE $14.00 12/18/02 A4 145,000 (1) 12/17/12 COMMON 145,000 145,000 D STOCK STOCK OPTION (RIGHT TO BUY) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: (1) One-third of the options become exercisable on January 1, 2004, and the remaining options become exercisable in 24 equal monthly installments beginning February 1, 2004. /S/ ROBERT L. ANTIN February 12, 2003 -------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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. Page 2