-----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, TZcrlTL8ao5ITYGctnSy41bzOMZgLQchfZ3cQFGLFRlwCjzL6GoGva5u4UaYs3YB zlGLQlxZ8rDCCkBEZr73+A== 0000769993-99-000277.txt : 19990217 0000769993-99-000277.hdr.sgml : 19990217 ACCESSION NUMBER: 0000769993-99-000277 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981231 FILED AS OF DATE: 19990216 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NEUROMEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000866933 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TESTING LABORATORIES [8734] IRS NUMBER: 133526980 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-26984 FILM NUMBER: 99542499 BUSINESS ADDRESS: STREET 1: 10 MOUNTAIN VIEW ROAD STREET 2: SUITE C-100 CITY: UPPER SADDLE RIVER STATE: NJ ZIP: 07458-1933 BUSINESS PHONE: 2019340660 MAIL ADDRESS: STREET 1: 10 MOUNTAIN VIEW ROAD STREET 2: SUITE C-100 CITY: UPPER SADDLE RIVER STATE: NJ ZIP: 07458-1933 COMPANY DATA: COMPANY CONFORMED NAME: GOLDMAN SACHS GROUP LP CENTRAL INDEX KEY: 0000904571 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] OWNER IRS NUMBER: 133501777 STATE OF INCORPORATION: NY FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 85 BROAD ST CITY: NEW YORK STATE: NY ZIP: 10004 BUSINESS PHONE: 2129021000 MAIL ADDRESS: STREET 1: 85 BROAD STREET CITY: NEW YORK STATE: NY ZIP: 10004 5 1 ANNUAL STATEMENT/CHANGES IN BENEFICIAL OWNERSHIP UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 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(f) of the Investment Company Act of 1940 [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported ================================================================================ 1. Name and Address of Reporting Person* The Goldman Sachs Group, L.P. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 85 Broad Street - -------------------------------------------------------------------------------- (Street) New York, New York 10004 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Neuromedical Systems, Inc. (NSIX) ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) ================================================================================ 4. Statement for Month/Year FYE December 31, 1998 ================================================================================ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ X ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) -------------------------------------------------- ================================================================================ 7. Individual or Joint/Group Reporting (Check applicable line) [ ] Form Filed by One Reporting Person [ X ] Form Filed by More than One Reporting Person ================================================================================
==================================================================================================================================== Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ==================================================================================================================================== | | | | | | | | | | |5. |6. | | | | |4. |Amount of |Owner- | | | | |Securities Acquired (A) or |Securities |ship | | | | |Disposed of (D) |Beneficially |Form: |7. | | | |(Instr. 3, 4 and 5) |Owned at end |Direct |Nature of | |2. | 3. |-------------------------------|of Issuer's |(D) or |Indirect | 1. |Transaction |Transaction | | (A) | |Fiscal Year |Indirect |Beneficial| Title of Security |Date |Code | Amount | or | Price |(Instr. 3 |(I) |Ownership | (Instr. 3) |(Month/Day/Year) |(Instr. 8) | | (D) | |and 4) |(Instr.4)|(Instr. 4)| - ------------------------------------------------------------------------------------------------------------------------------------ | | | | | | | | | Common Stock | | | | | | 6,839,699 | 01 | 01 | - ------------------------------------------------------------------------------------------------------------------------------------ | | | | | | | | | | | | | | | | | | ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). FORM 5 (continued)
==================================================================================================================================== Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned | (e.g., puts, calls, warrants, options, convertible securities) | ==================================================================================================================================== | | | | | | | | | | | | | | | | | | |9. |10. | | | | | | | | | |Number |Owner-| | | | | | | | | |of |ship | | |2. | | | | | | |Deriv- |of | | |Conver-| | |5. | |7. | |ative |Deriv-|11. | |sion | | |Number of | |Title and Amount | |Secur- |ative |Nature| |or | | |Derivative |6. |of Underlying |8. |ities |Secur-|of | |Exer- | | |Securities |Date |Securities |Price |Bene- |ity: |In- | |cise |3. | |Acquired (A) |Exercisable and |(Instr. 3 and 4) |of |ficially |Direct|direct| |Price |Trans- |4. |or Disposed |Expiration Date |--------------------|Deriv- |Owned |(D) or|Bene- | 1. |of |action |Trans-|of (D) |(Month/Day/Year) | |Amount |ative |at End |In- |ficial| Title of |Deriv- |Date |action|(Instr. 3, |---------------------| |or |Secur- |of |direct|Owner-| Derivative |ative |(Month/ |Code |4 and 5) |Date |Expira- | |Number |ity |Year |(I) |ship | Security |Secur- |Day/ |(Instr|---------------|Exer- |tion | |of |(Instr.|(Instr. |(Instr|(Instr| (Instr. 3) |ity |Year) |8) | (A) |(D) |cisable |Date |Title |Shares |5) |4) |4) |4) | - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock| | | | | | | | | | | | | | Options (right| | | | | | | | | | | | | | to buy) |$2.12 | 5/8/98 | A(02)| 2,500 | | 11/9/98 | 5/8/08 |Common Stock| 2,500 | | 2,500 | 02 | 02 | - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock| | | | | | | | | | | | | | Options (right| | | | | | | | | | | | | | to buy) |$7.375 | | | | | 11/17/97 | 5/16/07 |Common Stock| 5,000 | | 5,000 | 02 | 02 | - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock| | | | | | | | | | | | | | Options (right| | | | | | | | | | | | | | to buy) |$16.88 | | | | | 12/22/96 | 6/21/06 |Common Stock| 5,000 | | 5,000 | 02 | 02 | - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock| | | | | | | | | | | | | | Options (right| | | | | | | | | | | | | | to buy) |$7.00 | | | | | 4/26/96 | 10/25/05 |Common Stock| 2,500 | | 2,500 | 02 | 02 | - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock| | | | | | | | | | | | | | Options (right| | | | | | | | | | | | | | to buy) |$6.00 | | | | | 6/1/95 | 6/1/05 |Common Stock| 2,500 | | 2,500 | 02 | 02 | ====================================================================================================================================
Instruction 4(b)(v) list of other Reporting Persons: This statement is being filed by GS Capital Partners, L.P. ("GSCP"), Stone Street Fund 1993, L.P. ("Stone Street 1993"), Bridge Street Fund 1993, L.P. ("Bridge Street 1993" and, together with GSCP and Stone Street 1993, the "Limited Partnerships"), GS Advisors, L.P. ("GS Advisors"), Stone Street Resource Corp. ("Resource"), Goldman, Sachs & Co. ("Goldman Sachs") and The Goldman Sachs Group, L.P. ("GS Group" and, together with GSCP, GS Advisors, Stone Street 1993, Bridge Street 1993, Resource and Goldman Sachs, the "Reporting Persons"). The principal business address of each of the Reporting Persons is 85 Broad Street, New York, NY 10004. Explanation of Responses: 01: GS Group may be deemed to own beneficially and directly 125,000 shares of Common Stock and Goldman Sachs and GS Group may be deemed to own beneficially and indirectly in the aggregate 6,714,699 shares of Common Stock through the Limited Partnerships. GS Group is the general partner of and owns a 99% interest in Goldman Sachs. Goldman Sachs is the investment manager of GSCP. Affiliates of Goldman Sachs and GS Group are the general partner, managing general partner or managing partner of the Limited Partnerships. Goldman Sachs and GS Group each disclaim beneficial ownership of the shares of Common Stock owned by the Limited Partnerships except to the extent of their pecuniary interest therein. GSCP may be deemed to own beneficially and directly, and its general partner GS Advisors may be deemed to own beneficially and indirectly, 5,371,758 shares of Common Stock. GS Advisors disclaims beneficial ownership of the securities reported herein except to the extent of its pecuniary interest therein. Stone Street 1993 may be deemed to own beneficially and directly, and its general partner Resource may be deemed to own beneficially and indirectly, 634,673 shares of Common Stock. Resource disclaims beneficial ownership of the securities reported herein except to the extent of its pecuniary interest therein. Bridge Street 1993 may be deemed to own beneficially and directly and its managing general partner Resource may be deemed to own beneficially and indirectly, 708,268 shares of Common Stock. Resource disclaims beneficial ownership of the securities reported herein except to the extent of its pecuniary interest therein. 02: These options were granted under the Neuromedical Systems, Inc. 1993 Stock Incentive Plan to a managing director and a former officer of Goldman Sachs in their capacity as directors of the Issuer. That managing director and that former officer have an agreement with GS Group pursuant to which they hold the options for the benefit of GS Group. Signatures: GOLDMAN, SACHS & CO. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact THE GOLDMAN SACHS GROUP, L.P. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact GS CAPITAL PARTNERS, L.P. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact GS ADVISORS, L.P. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact STONE STREET FUND 1993, L.P. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact BRIDGE STREET FUND 1993, L.P. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact STONE STREET RESOURCE CORP. By: s/ Hans L. Reich ----------------------- Name: Hans L. Reich Title: Attorney-in-fact Date: February 16, 1999 ** 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 procedure. Alternatively, this Form is permitted to be submitted to the Commission in electronic format at the option of the Reporting Person pursuant to Rule 101(b)(4) of Regulation S-T. -----END PRIVACY-ENHANCED MESSAGE-----