-----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, KCEptuZ/BrHGokOKl0BkenAMecUUy+yFqUzXlGy1ih2wRIUJ0yd6wJACil0G+ovy Qpo6ZojcA4++KPwdUd8vHA== 0000897101-03-001347.txt : 20031027 0000897101-03-001347.hdr.sgml : 20031027 20031027133015 ACCESSION NUMBER: 0000897101-03-001347 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031023 FILED AS OF DATE: 20031027 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MELLOR JAMES E CENTRAL INDEX KEY: 0001267596 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19467 FILM NUMBER: 03958092 MAIL ADDRESS: STREET 1: 1771 EAST 30TH STREET CITY: CLEVELAND STATE: OH ZIP: 44114 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MEDAMICUS INC CENTRAL INDEX KEY: 0000833140 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411533300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 15301 HGHWY 55 W CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 7635592613 4 1 medm034500mellor_4ex.xml X0201 4 2003-10-23 0 0000833140 MEDAMICUS INC MEDM 0001267596 MELLOR JAMES E 1771 EAST 30TH STREET CLEVELAND OH 44114 0 1 0 0 Sr. VP of Medacquisition Common Stock 0 D Option (right to buy) 10.93 2003-10-23 4 A 0 30000 10.93 A 2003-10-23 2009-10-23 Common Stock 30000 30000 D /s/ Kimberly Gessner by Power of Attorney 2003-10-24 -----END PRIVACY-ENHANCED MESSAGE-----