-----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, EY4GxyPFvWsyKnruPmJZjRYzwTVoS1R/3ayFhP8Yrwb9dL1gG5n/kS69Shxs/unM ztBolHix11MrkyPflWmgDw== 0001104659-03-006154.txt : 20030408 0001104659-03-006154.hdr.sgml : 20030408 20030408121946 ACCESSION NUMBER: 0001104659-03-006154 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030408 FILED AS OF DATE: 20030408 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: WELDON KENT R CENTRAL INDEX KEY: 0001214214 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: C/O MTHOMAS H LEE PARTNERS LP STREET 2: 75 STATE STREEET CITY: BOSTON STATE: MA ZIP: 02109 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FISHER SCIENTIFIC INTERNATIONAL INC CENTRAL INDEX KEY: 0000880430 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-PROFESSIONAL & COMMERCIAL EQUIPMENT & SUPPLIES [5040] IRS NUMBER: 020451017 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10920 FILM NUMBER: 03642338 BUSINESS ADDRESS: STREET 1: LIBERTY LANE CITY: HAMPTON STATE: NH ZIP: 03842 BUSINESS PHONE: 6039265911 MAIL ADDRESS: STREET 1: LIBERTY LANE CITY: LIBEHAMPTON STATE: NH ZIP: 03842 4 1 j9345_4.htm 4

FORM 4

 o Check this box if no longer subject to Section 16.  Form 4 or Form 5 obligations may continue.
See Instruction 1(b).

(Print or Type Responses)

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, Section
17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the
Investment Company Act of 1940

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 1. Name and Address of Reporting Person *



Weldon        Kent        R.      

(Last)            (First)              (Middle)


c/o Thomas H. Lee Partners, L.P.

75 State Street

(Street)


Boston      MA           02109

(City)       (State)          (Zip)

 

 2. Issuer Name and Ticker
    or Trading Symbol

Fisher Scientific International, Inc. (FSH)

 

 3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)



 4. Statement for
 Month/Day/Year

4/8/03

 



 5. If Amendment, Date of
   Original (Month/Day/Year)



 6. Relationship of Reporting Person(s) to Issuer

(Check all applicable)

 X  Director

 

      Officer (give title below)

 

      10% Owner

 

      Other (specify below)

 

 


 7. Individual or Joint/Group
     Filing (Check Applicable Line)

  Form filed by One Reporting Person

      Form filed by More than One Reporting Person

 

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

 

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, par value $.01 per share

4/8/03

 

J (1)

 

5,977,006

D

 

- 0 -

I

See Note (1)

Common Stock, par value $.01 per share

4/8/03

 

J (1)

 

563

A (2)

 

12,769

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

 

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 Underlying Securities
(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 of Derivative Securities: 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

(1)   Represents shares of the issuer held directly by Thomas H. Lee Equity Fund III, L.P. (“Equity Fund III”), THL FSI Equity Investors, L.P. (“FSI”) and Thomas H. Lee Foreign Fund III, L.P. (“Foreign Fund III”), which the reporting person may be deemed to beneficially own.  On April 8, 2003 Equity Fund III, Foreign Fund III, FSI, and Equity Advisors III issued a pro rata distribution of common stock of the Issuer to their respective general and limited partners.  The reporting person disclaims beneficial ownership of such shares, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for the purpose of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein.

(2)   Represents shares distributed to the reporting person in connection with the distribution described in footnote (1) above.

 

 

 

/s/ Kent R. Weldon

** Signature of Reporting Person

April 8, 2003

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.

 

 

http://www.sec.gov/divisions/corpfin/forms/form4.htm

Last update: 09/05/2002

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