-----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, JwkJTXIdX5YO385rAXH536/FK6k/N3lnClc4RkEfzPzP0bi0we6p8O2S96ij9zS/ jCyp2uhYNt/+hHMnEowrIQ== 0001242661-05-000113.txt : 20050825 0001242661-05-000113.hdr.sgml : 20050825 20050825161040 ACCESSION NUMBER: 0001242661-05-000113 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050823 FILED AS OF DATE: 20050825 DATE AS OF CHANGE: 20050825 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: 051049035 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 c0001248750d20050825f4s1f.xml PRIMARY DOCUMENT X0202 4 2005-08-23 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 2005-08-23 4 M 0 15743 24 A 44213 D Common Stock 2005-08-23 4 S 0 15743 62.9848 D 28470 D Common Stock 3812 I Shares held in Rabbi Trust Stock Options (Right to buy) 24 2005-08-23 4 M 0 15743 0 D 2002-05-03 2011-05-03 Common Stock 15743 86136 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 August 23, 2005, actual denominations are as follows: 200 shares at $62.76; 800 shares at $62.77; 200 shares at $62.78; 800 shares at $62.80; 800 shares at $62.81; 100 shares at $62.82; 1,000 shares at $62.85; 300 shares at $62.86; 300 shares at $62.87; 1,000 shares at $62.90; 1,000 shares at $62.93; 243 shares at $62.94; 1,000 shares at $62.95; 1,000 shares at $62.98; 1,000 shares at $63.00; 800 shares at $63.01; 1,000 shares at $63.05; 200 shares at $63.06; 900 shares at $63.18; 900 shares at $63.19; 2,100 shares at $63.20; 100 shares at $63.30. 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 2005-08-25 -----END PRIVACY-ENHANCED MESSAGE-----