FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
ALLION HEALTHCARE INC [ NONE ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/01/1999 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 02/01/1999 | 02/01/1999 | P(1) | 325,000 | A | $0.4 | 325,000 | D | ||
Common Stock | 02/01/1999 | 02/01/1999 | P(1) | 475,000 | A | $0.4 | 475,000 | I | By Halkis Ltd. | |
Common Stock | 02/01/1999 | 02/01/1999 | P(1) | 250,000 | A | $0.4 | 250,000 | I | By Thebes Ltd.(2) | |
Common Stock | 03/01/2000 | 03/01/2000 | M | 50,000 | A | $0.175 | 375,000 | D | ||
Common Stock | 12/31/2000 | 12/31/2000 | G | 100,000 | D | $0.4 | 375,000 | I | By Halkis Ltd. |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option (right to buy) | $0.175 | 02/01/1999 | 02/01/1999 | A | 50,000 | 02/01/1999 | 02/01/2009 | Common Stock | 50,000 | $0 | 50,000 | D | |||
Common Stock Warrant (right to buy) | $1 | 01/11/2000 | 01/11/2000 | J(3) | 375,000 | 01/11/2000 | 01/11/2010 | Common Stock | 375,000 | $0 | 375,000 | D | |||
Stock Option (right to buy) | $0.175 | 03/01/2000 | 03/01/2000 | M | 50,000 | 02/01/1999 | 02/01/2009 | Common Stock | 50,000 | $0 | 0 | D | |||
Stock Option (right to buy) | $2 | 12/05/2000 | 12/05/2000 | A | 50,000 | (6) | 12/05/2010 | Common Stock | 50,000 | $0 | 50,000 | D | |||
Common Stock Warrant (right to buy) | $1 | 02/25/2002 | 02/25/2002 | G | 37,500 | 01/11/2000 | 01/11/2010 | Common Stock | 37,500 | $0 | 337,500 | D | |||
Common Stock Warrant (right to buy) | $3.5 | 06/30/2002 | 06/30/2002 | J(4) | 150,000 | 06/30/2002 | 06/30/2012 | Common Stock | 150,000 | $0 | 150,000 | D | |||
Common Stock Warrant (right to buy) | $5 | 04/01/2003 | 04/01/2003 | J(5) | 125,000 | 04/01/2003 | 04/01/2013 | Common Stock | 125,000 | $0 | 125,000 | D | |||
Common Stock Warrant (right to buy) | $5 | 04/01/2003 | 04/01/2003 | G | 110,000 | 04/01/2003 | 04/01/2013 | Common Stock | 110,000 | $0 | 15,000 | D | |||
Series C Convertible Preferred Stock | $5(7) | 04/01/2003 | 04/01/2003 | P | 100,000 | 04/01/2003 | (8) | Common Stock | 100,000 | $0 | 100,000 | D |
Explanation of Responses: |
1. The shares were purchased in connection with the bankruptcy reorganization of the issuer. Any securities of the issuer beneficially owned by the reporting person prior to the bankruptcy reorganization were eliminated in the reorganization. |
2. Thebes is controlled by the wife of the reporting person, and the reporting person disclaims beneficial ownership of these shares and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for Section 16 or for any other purpose. |
3. The Common Stock Warrant was granted to the reporting person in exchange for the reporting person personally guaranteeing a term loan made to the issuer. |
4. The Common Stock Warrant was granted in connection with the continuation of the personal guarantee referred to in (3) above. |
5. The Common Stock Warrant was granted in connection with the subordination of the reporting person's security interest in certain of the issuer's assets. |
6. The option vests monthly over 36 months from December 5, 2000, the date of grant of such options. |
7. Subject to adjustment per the Certificate of Designation of Rights and Preferences of Series C Preferred Stock of Issuer. |
8. No expiration date. |
JAMES G. SPENCER, BY POWER OF ATTORNEY | 05/20/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |