-----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, WujYDE+IVoIkNOo26pH4QE8bMjVf/neRmqpI0TBYys7VGh9swliG6h6CzgeABub8 eCbKxdCNDNPMWe/SlWxrXA== 0000950147-03-000153.txt : 20030212 0000950147-03-000153.hdr.sgml : 20030212 20030212124437 ACCESSION NUMBER: 0000950147-03-000153 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021130 FILED AS OF DATE: 20030212 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: KELLY SHANE P CENTRAL INDEX KEY: 0001190925 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 MAIL ADDRESS: STREET 1: 1275 W WASHINTON CITY: TEMPE STATE: AR ZIP: 85281 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ORTHOLOGIC CORP CENTRAL INDEX KEY: 0000887151 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 860585310 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21214 FILM NUMBER: 03553295 BUSINESS ADDRESS: STREET 1: 1275 WEST WASHINGTON STREET CITY: TEMPE STATE: AZ ZIP: 85281 BUSINESS PHONE: 6024375520 MAIL ADDRESS: STREET 1: 1275 WEST WASHINGTON STREET CITY: TEMPE STATE: AZ ZIP: 85281 5 1 e-9574.txt FORM 5 OF SHANE P. KELLY ------------------------------ OMB APPROVAL ------------------------------ - ------ OMB Number: 3235-0362 FORM 5 Expires: January 31, 2005 - ------ Estimated average burden hours per response ....... 1.0 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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 [ ] Check this box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [ ] Form 3 Holdings Report [X] Form 4 Transactions Reported ================================================================================ 1. Name and Address of Reporting Person* Kelly Shane P. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 1275 West Washington Street - -------------------------------------------------------------------------------- (Street) Tempe Arizona 85281 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name AND Ticker or Trading Symbol OrthoLogic Corp. (OLGC) ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) ================================================================================ 4. Statement for Month/Year November 30, 2002 ================================================================================ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) V.P. - Sales ------------------------------------ ================================================================================ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by One Reporting Person [ ] Form filed by More Than one Reporting Person ================================================================================ Page 1 of 3 Form 5 (continued) Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
======================================================================================================================== | | | | | | | | | | | | 5. Amount| | | | | | | of Secur-| | | | | | 4. | ities | | 7. | | | | Securities | Bene- | | Nature | | | | Acquired (A) | ficially | 6. Owner-| of | | | | or Disposed | Owned at | ship | Indirect | | 2A. | | of (D) (Instr. | End of | Form: | Bene- | | Deemed | | 3, 4 and 5) | Issuer's | Direct | ficial | 2. Trans- | Execution | 3. | ---------------- | Fiscal | (D) or | Owner- | action Date | Date, if any| Transaction | |(A)| | Year | Indirect | ship 1. Title of Security | (Month/Day/ | (Month/Day/ | Code | Amount|or |Price | (Instr. | (I) | (Instr. (Instr. 3) | Year) | Year) | (Instr. 8) | |(D)| | 3 and 4) | (Instr.4)| 4) - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ ========================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). Page 2 of 3 Form 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
========================================================================================================================= | | | | |5. | | | | 9. |10. | | | | | |Number | | | | Number |Owner-| | | | | |of | |7. | | of |ship | |2. | | | |Deriv- | |Title and | | Deriv- |of | |Conver-| | | |ative | |Amount of | | ative |Deriv-|11. |sion | | | |Secur- | |Underlying | | Secur- |ative |Nature |of | |3A. | |ities |6. |Securities |8. | ities |Secur-|of |Exer- | |Deemed | |Acquired |Date |(Instr. 3 |Price | Bene- |ity: |In- |cise |3. |Execu- | |(A) or |Exercisable and |and 4) |of | ficially|Direct|direct |Price |Trans- |tion |4. |Disposed |Expiration Date |-------------|Deriv- | Owned |(D) or|Bene- 1. |of |action |Date, |Trans- |of(D) |(Month/Day/Year) | |Amount|ative | at End |In- |ficial Title of |Deriv- |Date |if any |action |(Instr.3,|-----------------| |or |Secur- | of |direct|Owner- Derivative |ative |(Month/ |(Month/ |Code |4 and 5) |Date | Expira-| |Number|ity | Year |(I) |ship Security |Secur- |Day/ |Day/ |(Instr.|-------- |Exer- | tion | |of |(Instr.| (Instr. |(Instr|(Instr. (Instr. 3) |ity |Year) |Year) |8) |(A) | (D)|cisable | Date |Title |Shares|5) | 4) |4) |4) - ------------------------------------------------------------------------------------------------------------------------- Stock Option $3.50 11/11/02 A 32,000 (1) 11/11/12 Common 32,000 32,000 D (Right to buy) Stock - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- =========================================================================================================================
Explanation of Responses: (1) Vests as to 8,000 shares on November 11, 2003 and as to 666.667 shares monthly thereafter. By: Sherry A. Sturman 02/10/03 - ------------------------------- ------------ **Signature of Reporting Person Date Attorney-in-Fact ** 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 provided is insufficient, see Instruction 6 for procedures. Page 3 of 3 -----END PRIVACY-ENHANCED MESSAGE-----