-----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, CZ7p8GUX4bBf8gNOoXGoomEmT3y5wr1atQkwXBzhjU1XfkFk6wxUQv1yzJfx5Ref X8vrO3A97ad1Ge/NkNPu8A== 0001242661-05-000083.txt : 20050630 0001242661-05-000083.hdr.sgml : 20050630 20050630164347 ACCESSION NUMBER: 0001242661-05-000083 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050628 FILED AS OF DATE: 20050630 DATE AS OF CHANGE: 20050630 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLARK KEVIN P CENTRAL INDEX KEY: 0001248750 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10920 FILM NUMBER: 05928992 BUSINESS ADDRESS: STREET 1: LIBERTY LANE CITY: HAMPTON STATE: NH ZIP: 03842 ISSUER: 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 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 c0001248750d20050630f4f.xml PRIMARY DOCUMENT X0202 4 2005-06-28 0 0000880430 FISHER SCIENTIFIC INTERNATIONAL INC FSH 0001248750 CLARK KEVIN P LIBERTY LANE HAMPTON NH 03842 0 1 0 0 Vice President & CFO Common Stock 2005-06-28 4 M 0 8365 9.5 A 36835 D Common Stock 2005-06-28 4 M 0 7378 24 A 44213 D Common Stock 2005-06-28 4 S 0 15743 64.0449 D 28470 D Common Stock 3812 I Shares held in Rabbi Trust Stock Options (Right to buy) 9.5 2005-06-28 4 M 0 8365 0 D 1999-01-21 2008-01-21 Common Stock 8365 0 D Stock Options (Right to buy) 24 2005-06-28 4 M 0 7378 24 D 2002-05-03 2011-05-03 Common Stock 7378 117622 D The exercise and sale of the option shares were accomplished pursuant to a 10b5-1(c) plan adopted on December 8th, 2004. The sales price shown is the aggregate sales price for all the option shares sold on June 28, 2005, actual denominations are as follows: 500 shares at $63.89; 1,000 shares at $63.95; 1,300 shares at $63.96; 500 shares at $63.97; 300 shares at $63.98; 300 shares at $63.99; 243 shares at $64.00; 2,200 shares at $64.01; 2,000 shares at $64.03; 500 shares at $64.04; 900 shares at $64.06; 100 shares at $64.07; 400 shares at $64.08; 1,500 shares at $64.09; 100 shares at $64.10; 300 shares at $64.11; 400 shares at $64.12; 700 shares at $64.13; 1,000 shares at $64.14; 500 shares at $64.15; 900 shares at $64.16; 100 shares at $64.17. Options (right to buy) became exercisable in equal installments on each of the first five anniversaries of the date of grant. 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 2005-06-30 -----END PRIVACY-ENHANCED MESSAGE-----