-----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, HAxnF5c4o4Zmb4EC+2LZxFLzH48zI82kktlscTkxYLtCvWAEIr53U26CwudCV5vn JL7IqjZ0e7puXSFfDnf7Pw== 0000950135-96-001359.txt : 19960312 0000950135-96-001359.hdr.sgml : 19960312 ACCESSION NUMBER: 0000950135-96-001359 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960311 SROS: NYSE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHSOURCE INC CENTRAL INDEX KEY: 0000855587 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 020387748 STATE OF INCORPORATION: NH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-40671 FILM NUMBER: 96533470 BUSINESS ADDRESS: STREET 1: 2 COLLEGE PARK DRIVE CITY: HOOKSETT STATE: NH ZIP: 03302-2041 BUSINESS PHONE: 6032687000 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SHEEHAN PHINNEY BASS GREEN PROFESSIONAL ASSOCIATION/FA CENTRAL INDEX KEY: 0000915894 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] STATE OF INCORPORATION: NH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 1000 ELM STREET CITY: MANCHESTER STATE: NH ZIP: 03105-3701 MAIL ADDRESS: STREET 1: P.O. BOX 3701 CITY: MANCHESTER STATE: NH ZIP: 03105-3701 FORMER COMPANY: FORMER CONFORMED NAME: SHEEHAN PHINNEY BASS GREEN PROFESSIONAL ASSOCIATION DATE OF NAME CHANGE: 19931208 SC 13G/A 1 HEALTHSOURCE, INC. AMENDMENT NO. 6 1 SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 6) HEALTHSOURCE, INC. - -------------------------------------------------------------------------------- (Name of Issuer) COMMON STOCK $.10 PAR VALUE - -------------------------------------------------------------------------------- (Title of Class of Securities) 42221E 10 4 - -------------------------------------------------------------------------------- (CUSIP Number) Check the following box if a fee is being paid with this statement / /. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7.) *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 ("Act") 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). Page 1 of 5 Pages 2 CUSIP NO. 42221E 10 4 13G PAGE 2 OF 5 PAGES - -------------------------------------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Norman C. Payson, M.D. SS# ###-##-#### - -------------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) / / (b) /XX/ - -------------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 5,172,760 BENEFICIALLY ------------------------------------------------------------------------------------------ OWNED BY 6 SHARED VOTING POWER EACH Not Applicable REPORTING ------------------------------------------------------------------------------------------ PERSON 7 SOLE DISPOSITIVE POWER WITH 5,172,760 ------------------------------------------------------------------------------------------ 8 SHARED DISPOSITIVE POWER Not Applicable - --------------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 5,172,760 - -------------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* Not Applicable - -------------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 8% - -------------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------
*SEE INSTRUCTION BEFORE FILLING OUT! 3 CUSIP NO. 42221E 10 4 Page 3 of 5 Pages Item 1: (a) Name of Issuer: Healthsource, Inc. (b) Address of Issuer's Principal Executive Offices: Two College Park Drive Hooksett, NH 03106 Item 2: (a) Name of Person Filing: Norman C. Payson, M.D. President, Director and Chief Executive Officer (b) Address of Principal Business Office or, if none, Residence: Two College Park Drive Hooksett, NH 03106 (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, $.10 par value per share (e) CUSIP Number: 42221E 10 4
Item 3: If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b), check whether the person filing is a: Not Applicable. Item 4: Ownership: (a) Amount Beneficially Owned: 5,172,760 shares (includes options exercisable within 60 days to purchase 840,000 shares of Issuer Common Stock). 4 CUSIP NO. 42221E 10 4 Page 4 of 5 Pages (b) Percent of Class: 8% (based on 64,420,827 shares outstanding on December 31, 1995, including shares exercisable pursuant to Rule 13d-3(d)(1)) (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 5,172,760 shares (ii) shared power to vote or to direct the vote: Not Applicable (iii) sole power to dispose or to direct the disposition of: 5,172,760 shares (iv) shared power to dispose or to direct the disposition of: Not Applicable 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 Item 10: Certification: Not Applicable, as to Rule 13d-1(b)
5 SCHEDULE 13G Page 5 of 5 Pages 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. Date: March 4, 1996 /s/ NORMAN C. PAYSON ------------------------------- Norman C. Payson, M.D. MJD 71844750/.AG2 -----END PRIVACY-ENHANCED MESSAGE-----