3 1 lo-form3.txt INITIAL STATEMENT OF BENEFICIAL OWNERSHIP -------------- 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) May 21, 2001 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 Benage, Joseph C. (Voluntary) (Month/Day/Year) __Director __10% Owner X Officer __Other (give title below) (specify below) Executive Vice President, General Counsel and Secretary --------------------------------- ----------------------------- ------------------------ (Street) 7. Individual or Joint/ Group Filing (Check 12916 Delmar 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 Leawood, KS 66209 ------------------------------------------------------------------------------------------------------------------------------------ 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 Stock Option (right 05/11/2002 05/11/2011 Common Stock 80,000 $7.645 D to buy) (1) ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------ ---------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) The option vests in five equal annual installments commencing 5/11/2002, subject to accelerated vesting upon a change in control of the registrant. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Joseph C. Benage 5/31/2001 -------------------------- ------------------- Date 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