-----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, O7v/vaJzUvyHpnNrLfO8k5KtUTsNp3N+6d1T6SyjwTRKRv3T0of9WHgNC+o7CQng 7+kZ8HwEylANsN4qvAlk+A== 0001144204-07-005211.txt : 20070205 0001144204-07-005211.hdr.sgml : 20070205 20070205124830 ACCESSION NUMBER: 0001144204-07-005211 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070126 FILED AS OF DATE: 20070205 DATE AS OF CHANGE: 20070205 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PACE HEALTH MANAGEMENT SYSTEMS INC CENTRAL INDEX KEY: 0000943324 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 421297992 STATE OF INCORPORATION: IA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1025 ASHWORTH RD STREET 2: STE 200 CITY: WEST DES MOINES STATE: IA ZIP: 50265 BUSINESS PHONE: 5152221717 MAIL ADDRESS: STREET 1: 1025 ASHWORTH RD STREET 2: SUITE 200 CITY: W DES MOINES STATE: IA ZIP: 50265 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PAPPAJOHN JOHN CENTRAL INDEX KEY: 0000897464 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27554 FILM NUMBER: 07579357 BUSINESS ADDRESS: STREET 1: C/O EQUITY DYNAMICS STREET 2: 2116 FINANCIAL CENTER CITY: DES MOINES STATE: IA ZIP: 50309 BUSINESS PHONE: 631-870-5100 MAIL ADDRESS: STREET 1: 1660 WALT WHITMAN ROAD STREET 2: SUITE 105 CITY: MELVILLE STATE: NY ZIP: 11747 4 1 v064453_ex.xml X0202 4 2007-01-26 0 0000943324 PACE HEALTH MANAGEMENT SYSTEMS INC PCES 0000897464 PAPPAJOHN JOHN PACE HEALTH MANAGEMENT SYSTEMS, INC. 2116 FINANCIAL CENTER, 666 WALNUT STREET DES MOINES IA 50309 1 0 0 0 Common Stock 2007-01-26 4 A 0 1356522 0.50 A 2331740 D Series A Convertible Preferred Stock Common Stock 3000000 1500000 D The 1,356,522 shares of common stock were issued in exchange for $678,261 of accrued but unpaid dividends on the Series A Preferred Stock of the Issuer held by the reporting person. Pursuant to the Issuer's Articles of Incorporation, these dividends were converted into common stock on a two shares per dollar basis. Each share of the Series A Convertible Preferred Stock is convertible to two shares of common stock. The Series A Convertible Preferred Stock is convertible upon issuance. None /s/ John Pappajohn 2007-02-05 -----END PRIVACY-ENHANCED MESSAGE-----