-----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, LJtgE0qa0tT63ieE6qvetYwtfy5+ndjMFP/qFpkPGyr1eLXqUnBHrM1MwpdmV7MB W3/zx4Wuaz+/diBfasHnbg== 0000950134-96-003020.txt : 19960620 0000950134-96-003020.hdr.sgml : 19960620 ACCESSION NUMBER: 0000950134-96-003020 CONFORMED SUBMISSION TYPE: 10-C PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19960612 FILED AS OF DATE: 19960619 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: GULF SOUTH MEDICAL SUPPLY INC CENTRAL INDEX KEY: 0000889885 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 640831411 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 10-C SEC ACT: 1934 Act SEC FILE NUMBER: 000-23540 FILM NUMBER: 96583037 BUSINESS ADDRESS: STREET 1: 426 CHRISTINE DR CITY: RIDGELAND STATE: MS ZIP: 39157 BUSINESS PHONE: 6018565900 MAIL ADDRESS: STREET 1: 426 CHRISTINE DR CITY: RIDGELAND STATE: MS ZIP: 39157 10-C 1 FORM 10-C 1 SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 FORM 10-C REPORT BY ISSUER OF SECURITIES QUOTED ON NASDAQ INTERDEALER QUOTATION SYSTEM FILED PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF 1934 AND RULE 13A-17 OR 15D-17 THEREUNDER GULF SOUTH MEDICAL SUPPLY, INC. (Exact name of issuer as specified in charter) 426 CHRISTINE DRIVE, RIDGELAND, MISSISSIPPI 39157 (Address of principal executive offices) Issuer's telephone number, including area code: (601) 856-5900 I. CHANGE IN NUMBER OF SHARES OUTSTANDING Indicate any change (increase or decrease) of five percent or more in the number of shares outstanding: 1. Title of security: Common Stock, $.01 Par Value 2. Number of shares outstanding before the change: 14,040,847 3. Number of shares outstanding after the change: 16,264,123 4. Effective date of change: June 12, 1996 5. Method of change: Specify method (such as merger, acquisition, exchange, distribution, stock split, reverse split, acquisition of stock for treasury, etc.) Public offering Give brief description of transaction: In connection with a public offering of 3,000,000 shares of Common Stock by the issuer and certain selling stockholders, the issuer issued 2,223,276 shares of Common Stock. II. CHANGE IN NAME OF ISSUER 1. Name prior to change: N/A 2. Name after change: N/A 3. Effective date of charter amendment changing name: N/A 4. Date of shareholder approval of change, if required: N/A June 18, 1996 /s/ Stanton Keith Pritchard, Vice President Corporate Development - ------------------ ----------------------------------------------------------------- Date (Officer's signature and title)
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