-----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, HZSc26707XFtso65u9Bmh1SVvjgY5rtMvqW0lBfOp7QGEDgO+8wZq4W7iLpu73fe Tsl9W+Qd2yFiR5Mac56VPw== 0000897101-98-000106.txt : 19980212 0000897101-98-000106.hdr.sgml : 19980212 ACCESSION NUMBER: 0000897101-98-000106 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980211 SROS: NONE SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-45959 FILM NUMBER: 98530894 BUSINESS ADDRESS: STREET 1: 15301 HGHWY 55 W CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 6125592613 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LITTLE RICHARD L CENTRAL INDEX KEY: 0000938623 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 470329361 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 15301 HIGHWAY 55WEST CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 6125592613 MAIL ADDRESS: STREET 1: 15301 HIGHWAY 55 EAST CITY: PLYMOUTH STATE: MN ZIP: 55447 SC 13G/A 1 SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 -------------------- SCHEDULE 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b) AND (c) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2(b) (Amendment No. 3)(1) MedAmicus, Inc. ----------------------------------------------- (Name of Issuer) Common Stock, $.01 Par Value ----------------------------------------------- (Title of Class of Securities) 584027 10 6 ----------------------------------------------- (CUSIP Number) - --------------------- (1) The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the NOTES). CUSIP No. 584027 10 6 13G Page 2 of 5 Pages 1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) Richard L. Little 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| 3. SEC USE ONLY 4. CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A. 5. SOLE VOTING POWER NUMBER OF 196,200 SHARES 6. SHARED VOTING POWER BENEFICIALLY 188,200 OWNED BY EACH 7. SOLE DISPOSITIVE POWER REPORTING PERSON 196,200 WITH 8. SHARED DISPOSITIVE POWER 188,200 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 384,400 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 9.4% 12. TYPE OF REPORTING PERSON* IN *SEE INSTRUCTIONS BEFORE FILLING OUT! CUSIP No. 584027 10 6 13G Page 3 of 5 Pages Item 1(a). Name of Issuer: MedAmicus, Inc. Item 1(b). Address of Issuer's Principal Executive Offices: 15301 Highway 55 Plymouth, Minnesota 55447 Item 2(a). Name of Person Filing: See Item 1 on cover page Item 2(b). Address of Principal Business Office or, if None, Residence: c/o MedAmicus, Inc. 15301 Highway 55 Plymouth, Minnesota 55447 Item 2(c). Citizenship: See Item 4 on cover page Item 2(d). Title of Class of Securities: Common Stock, $.01 par value Item 2(e). CUSIP Number: See cover page Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b), check whether the person is a: (a) |_| Broker or dealer registered under Section 15 of the Act, (b) |_| Bank as defined in Section 3(a)(6) of the Act, (c) |_| Insurance Company as defined in Section 3(a)(19) of the Act, (d) |_| Investment Company registered under Section 8 of the Investment Company Act, (e) |_| Investment Adviser registered under Section 203 of the Investment Advisers Act of 1940, (f) |_| Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; SEE 13d-1(b)(1)(ii)(F), (g) |_| Parent Holding Company, in accordance with Rule 13d-1(b)(ii)(G); SEE Item 7, (h) |_| Group, in accordance with Rule 13d-1(b)(1)(ii)(H). CUSIP No. 584027 10 6 13G Page 4 of 5 Pages Item 4. Ownership. If the percent of the class owned, as of December 31 of the year covered by the statement, or as of the last day of any month described in Rule 13d-1(b)(2), if applicable, exceeds five percent, provide the following information as of that date and identify those shares which there is a right to acquire. (a) Amount beneficially owned: See Item 9 on cover page. (b) Percent of class: See Item 11 on cover page (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: See Item 5 on cover page (ii) Shared power to vote or to direct the vote: See Item 6 on cover page (iii) Sole power to dispose or to direct the disposition of: See Item 7 on cover page (iv) Shared power to dispose or to direct the disposition of: See Item 8 on cover page Item 5. Ownership of Five Percent or Less of a Class. Not applicable Item 6. Ownership of More than Five Percent on Behalf of Another Person. Not applicable Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Not applicable Item 8. Identification and Classification of Members of the Group. Not Applicable Item 9. Notice of Dissolution of Group. Not applicable CUSIP No. 584027 10 6 13G Page 5 of 5 Pages Item 10. Certification. Not applicable. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: February 10, 1998 /s/ Richard L. Little ----------------------------------------- Richard L. Little -----END PRIVACY-ENHANCED MESSAGE-----