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
FISHER SCIENTIFIC INTERNATIONAL INC [ FSH ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 06/15/2005 | ||||||||||||||||||||||||||
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 | 06/15/2005 | S(1) | 37,193 | D | $64.0788(2) | 37,194 | D | |||
Common Stock | 06/16/2005 | M(3) | 50,000 | A | $24 | 87,194 | D | |||
Common Stock | 06/16/2005 | S(3) | 50,000 | D | $63.7552(4) | 37,194 | D |
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 Options (Right to buy) | $24 | 06/16/2005 | M(3) | 50,000 | 05/03/2002(5) | 05/03/2011 | Common Stock | 50,000 | $0 | 100,000 | D |
Explanation of Responses: |
1. The sale of shares was accomplished pursuant to a 10b5-1(c) sales plan adopted on December 8, 2004 (amended on 5-12-05). |
2. The sales price shown is the aggregate sales price for the shares sold on June 15, 2005, actual denominations are as follows: 1,000 shares at $63.80; 2,500 shares at $63.81; 1,000 shares at $63.82; 600 shares at $63.84; 2,400 shares at $63.85; 500 shares at $63.88; 100 shares at $64.00; 1,200 shares at $64.01; 100 shares at $64.04; 800 shares at $64.05; 800 shares at $64.06; 400 shares at $64.07; 2,500 share at $64.08; 400 shares at $64.09; 3,200 shares at $64.10; 2,800 shares at $64.11; 1,500 shares at $64.12; 700 shares at $64.13; 1,700 shares at $64.15; 2,000 shares at 64.16; 600 shares at $64.17; 5,993 shares at $64.20; 100 shares at $64.21; 300 shares at $64.24; 1,700 shares at $64.25; 1,000 shares at $64.27; 1,200 shares at $64.29; 100 shares at $64.32. |
3. The exercise and sale of the option shares were accomplished pursuant to a 10b5-1(c) plan adopted on December 8th, 2004 (amended 5-12-05). |
4. The sales price shown is the aggregate sales price for all option shares sold on June 16, 2005, actual denominations are as follows: 600 shares at $63.35; 1,000 shares at $63.37; 2,200 shares at $63.38; 200 shares at $63.41; 100 shares at $63.42; 100 shares at $63.43; 400 shares at $63.49; 300 shares at $63.50; 100 shares at $63.51; 2,600 shares at $63.52; 2,400 shares at $63.54; 500 shares at $63.61; 1,100 shares at $63.62; 500 shares at $63.63; 900 shares at $63.64; 2,800 shares at $63.65; 100 shares at $63.66; 600 shares at $63.67; 300 shares at $63.68; 300 shares at $63.69; 3,100 shares at $63.70; 900 shares at $63.71; 300 shares at $63.72; 1,200 shares at $63.73; 300 shares at $63.74; 400 shares at $63.75; 100 shares at $63.76; 1,000 shares at $63.78; 300 shares at $63.80; 500 shares at $63.81; 500 shares at $63.82; 900 shares at $63.83; 1,300 shares at $63.84; 2,400 shares at $63.85; 3,200 shares at $63.87; 800 shares at $63.88; 1,300 shares at $63.89; 700 shares at $63.90; 100 shares at $63.91; 800 shares at $63.92; 500 shares at $63.93; 400 shares at $63.94; 8,300 shares at $63.95; 2,100 shares at $63.97; 900 shares at $63.98; 600 shares at $63.99. |
5. The shares underlying this stock option become vested and exercisable in three installments, as follows: 33.33% on the first anniversary of the award; 33.33% on the second anniversary of the award; and 33.33% on the third anniversary of the award. |
Carrie M. Kane | 06/17/2005 | |
** 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. |