-----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, QCz4vD/BVcKEocS3MkDmT8cqBHh6JKNT4tWwvf7niUQSfrPDDQAKjV4VvIz0op+G vL66dX14MHO9EukeBfWuSw== 0001144204-07-018041.txt : 20070410 0001144204-07-018041.hdr.sgml : 20070410 20070410160212 ACCESSION NUMBER: 0001144204-07-018041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070314 FILED AS OF DATE: 20070410 DATE AS OF CHANGE: 20070410 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Conmed Healthcare Management, Inc. CENTRAL INDEX KEY: 0000943324 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 421297992 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9375 CHESAPEAKE STREET STREET 2: SUITE 203 CITY: LA PLATA, STATE: MD ZIP: 20646 BUSINESS PHONE: 5152221717 MAIL ADDRESS: STREET 1: 9375 CHESAPEAKE STREET STREET 2: SUITE 203 CITY: LA PLATA, STATE: MD ZIP: 20646 FORMER COMPANY: FORMER CONFORMED NAME: PACE HEALTH MANAGEMENT SYSTEMS INC DATE OF NAME CHANGE: 19960118 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: 07758981 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 v071224_ex.xml X0202 4 2007-03-14 0 0000943324 Conmed Healthcare Management, Inc. CHMH 0000897464 PAPPAJOHN JOHN C/O CONMED HEALTHCARE MANAGEMENT, INC. 9375 CHESAPEAKE STREET, SUITE 203 LA PLATA MD 20646 1 0 1 0 Common Stock 2007-03-14 4 A 0 2391754 A 2497846 D Common Stock 5000 I See Notes Common Stock 5496 I See Notes Stock Options 2.55 2007-04-03 4 A 0 40000 0 A 2017-04-03 Common Stock 40000 40000 D The shares of common stock acquired herein were issued in connection with the conversion of 3,000,000 shares of the Company's Series A Convertible Preferred Stock, held by the reporting person, pursuant to the Plan of Recapitalization and Reorganization approved by the shareholders and the Board of Directors of the Company. The shares of common stock being reported reflect the Company's 1 for 20 reverse stock split approved by the Company's shareholders. The reporting person is the controlling shareowner of Halkis Ltd. which owns the 5,000 shares reported herein. The reporting person indirectly owns the 5,496 shares being reported herein via the John and Mary Pappajohn Scholarship Foundation. The stock options for 40,000 shares of the Issuer's common stock that are the subject of this report will vest over three (3) years and is contingent on the reporting person's continued service on the Board of Directors. 13,333 options will vest on April 3, 2008, and 1,111 options will vest after each month thereafter for the next 24 months, provided that the Reporting Person continues to serve on the Board of Directors. /s/ John Pappajohn 2007-04-09 -----END PRIVACY-ENHANCED MESSAGE-----