-----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, QvUt+5Y9CZ1F50taD5kDta3lRVlk3+lz5czUJ2pxTQ+X0E77UD2cffqhC/mUpfM3 fM1lfw+xjGA0XlLUb1vuiw== 0000929624-97-000674.txt : 19970605 0000929624-97-000674.hdr.sgml : 19970605 ACCESSION NUMBER: 0000929624-97-000674 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19970522 FILED AS OF DATE: 19970604 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FPA MEDICAL MANAGEMENT INC CENTRAL INDEX KEY: 0000920173 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 330604264 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24276 FILM NUMBER: 97618750 BUSINESS ADDRESS: STREET 1: 2878 CAMINO DEL RIO S STE 301 CITY: SAN DIEGO STATE: CA ZIP: 92108 BUSINESS PHONE: 6192957005 MAIL ADDRESS: STREET 1: 2878 CAMINO DEL RIO S #301 CITY: SAN DIEGO STATE: CA ZIP: 92108 COMPANY DATA: COMPANY CONFORMED NAME: FOUNDATION HEALTH CORPORATION CENTRAL INDEX KEY: 0000859493 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] 10% OWNER IRS NUMBER: 954288333 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 21660 OXNARD STREET CITY: WOODAND HILLS STATE: CA ZIP: 91367 BUSINESS PHONE: 8187196978 MAIL ADDRESS: STREET 1: 21660 OXNARD STREET CITY: WOODLAND HILLS STATE: CA ZIP: 91367 4 1 FORM 4 - -------- U.S. SECURITIES AND EXCHANGE COMMISSION -------------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- -------------------------------- [_] Check this box if no STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287 longer subject to Expires: September 30, 1998 Section 16. Form 4 Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Estimated average burden or Form 5 obligations Section 17(a) of the Public Utility Holding Company Act of 1935 hours per response.......... 0.5 may continue. See or Section 30(f) of the Investment Company Act of 1940 -------------------------------- Instruction 1(b). (Print or Type Responses) - ----------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of 2. Issuer Name and Ticker or 6. Relationship of Reporting Person to Issuer Reporting Person Trading Symbol (Check all applicable) * * Foundation Health Corporation FPA Medical Management, Inc. (FPAM) [_] Director [X] 10% Owner - ---------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS or Social 4. Statement for ____ Officer (give ____ Other (specify * Security Number of Month/Year title below) 3400 Data Drive Reporting Person below) (Voluntary) * * - -------------------------------- * ---------------------- -------------------------------------------- (Street) 68-0014772 5. If Amendment, 7. Individual or Joint/Group filing (Check * Date of Original Applicable Line) Rancho Cordova, CA 95670 (Month/Year) X Form filed by One Reporting Person * --- Form filed by More than One Reporting Person --- - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of (Instr. 3) action action or Disposed of (D) Securities ship Indirect Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial (Instr. 8) Owned at Direct Ownership (Month/ ------------------------------------------- End of Month (D) or In- (Instr. 4) Day/ (A) or (Instr. 3 direct (I) Year) Code V Amount (D) Price and 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 5/22/97 S 2,000,000 D $18.40 2,076,087 D - ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 5/23/97 S 1,000,000 D $18.50 1,076,087 D - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474(7-96)
12520530 FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Cover- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount of Security (Instr. 3) sion or action action Derivative cisable and Underlying Securities Exercise Date Code Securities Expiration (Instr. 3 and 4) Price of (Month/ (Instr. 8) Acquired (A) Date (Month/ Deriv- Day/ or Disposed Day/Year) ative Year) of (D) (Instr. ---------------------------------------- Security 3, 4, and 5) Date Expira- Amount or -------------------------------- Exer- tion Title Number of Code V (A) (D) cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 8. Price 9. Number 10. Ownership 11. Nature of Security (Instr. 3) of of Form of Indirect Deriv- Deriv- Derivative Beneficial ative ative Security: Ownership Security Securities Direct (D) (Instr. 4) (Instr. 5) Beneficially or Indirect Owned at (I) End of Month (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: ** Intentional misstatements or /s/ Jeffrey L. Elder 6/3/97 omissions of facts constitute ---------------------- -------------- Federal Criminal Violations. **Signature of Date See 18 U.S.C. 1001 and Reporting Person 15 U.S.C. 78ff(a). Jeffrey L. Elder Note: File three copies of Chief Financial Officer this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Page 2 Potential persons who are to respond to the SEC 1474(7-96) collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. 12520530 -----END PRIVACY-ENHANCED MESSAGE-----