3 1 0001.txt FORM 3 -------------- FORM 3 -------------- U. S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 Address of 2. Date of Event Requiring 4. Issuer Name and Ticker or Trading Symbol Reporting Person* Statement (Month/Day/Year) November 10, 2000 LabOne, Inc. ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. IRS or Social Security Number 5. Relationship of Reporting Person to 6. If Amendment, Date of of Reporting Person Issuer (Check all applicable) Original Hartman, Troy L. (Voluntary) (Month/Day/Year) __Director __10% Owner X Officer __Other (give title below) (specify below) Executive Vice President, ExamOne Affiliates & Corp. Offices ----------------------------- ------------------------ (Street) 7. Individual or Joint/ Group Filing (Check 13107 W. 127th Terrace applicable Line) X Form filed by One Reporting Person __ Form filed by More than One Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) Table 1 - Non-Derivative Securities Beneficially Owned Overland Park, Kansas 66213 ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of 3. Ownership 4. Nature of Indirect Securities Form: Direct Beneficial Ownership Beneficially Owned (D) or Indirect (Instr. 5) (Inst. 4) (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ * If the Form is filed by more than one Reporting Person, see instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) PAGE 1 OF 2 PAGES (Table Continued) FORM 3 (cont'd.) Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Date exer- 3. Title and 4. Conver- 5. Ownership 6. Nature of Derivative cisable and Amount of sion or Form of Indirect Security Expiration Securities Exercise Derivative Beneficial (Inst. 4) Date (Month/ Underlying Price of Security: Ownership Day/Year) Derivative Derivative Direct (d) (Instr. 5) Security Security or Indirect (Inst. 4) (I) (Instr. 5) -------------------------------------------------- Date Expira- Amount Exer- Tion Title or Number cisable Date of Shares ------------------------------------------------------------------------------------------------------------------------------------ Employee Longterm Incentive 02/10/2005 02/10/2010 Common Stock 5,000 $6.9375 D Stock Plan (02/10/00) ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Troy L. Hartman 11/21/00 -------------------------- ------------------- Troy L. Hartman by Randy Date Shelton as attorney-in-fact 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 OF 2 PAGES