-----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, BPeg+yhoxdQYIS0y4p2rqUOMxFMSXF4Bhb9Fo4rKxvkbs4z51mIQ2gcZqvrTVGQn Sxq3qJdxv2lCCy3ZlSZubg== 0000897101-96-000293.txt : 19960619 0000897101-96-000293.hdr.sgml : 19960619 ACCESSION NUMBER: 0000897101-96-000293 CONFORMED SUBMISSION TYPE: 10-C PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19960513 FILED AS OF DATE: 19960517 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: MEDAMICUS INC CENTRAL INDEX KEY: 0000833140 STANDARD INDUSTRIAL CLASSIFICATION: 3841 IRS NUMBER: 411533300 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 10-C SEC ACT: 1934 Act SEC FILE NUMBER: 000-19467 FILM NUMBER: 96569307 BUSINESS ADDRESS: STREET 1: 15301 HGHWY 55 W CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 6125592613 10-C 1 FORM 10-C Securities and Exchange Commission Washington, D.C. 20549 Report by issuer of securities quoted on The Nasdaq Stock Market(sm), filed pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 and Rule 13a-17 or 15d-17 thereunder. EXACT NAME OF ISSUER AS SPECIFIED IN CHARTER: MedAmicus, Inc. ADDRESS OF PRINCIPAL EXECUTIVE OFFICES: 15301 Highway 55 West Plymouth, MN 55441 ISSUER'S TELEPHONE NUMBER (INCLUDING AREA CODE): (612) 559-2613 I. CHANGE IN NUMBER OF SHARES OUTSTANDING Indicate any change (increase or decrease) of five percent or more in the number of shares outstanding: 1. Title of security: Common Stock, $.01 par value 2. Number of shares outstanding before the change: 3,450,774 3. Number of shares outstanding after the change: 4,060,774 4. Effective date of change: May 13, 1996 5. Method of change: Issuance of New Shares Specify method (such as merger, acquisition, exchange, distribution, stock split, reverse split, acquisition of stock for treasury, etc.): original issuance Give brief description of transaction: private placement II. CHANGE IN NAME OF ISSUER 1. Name prior to change: 2. Name after change: 3. Effective date of charter amendment changing name: 4. Date of shareholder approval of change, if required: Date: May 13, 1996 /S/ JAMES D. HARTMAN --------------------- James D. Hartman, President and Chief Executive Officer -----END PRIVACY-ENHANCED MESSAGE-----