4 1 dn1202form-4b.txt ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response.........0.5 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 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 to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print of Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Nociolo Don R. -------------------------------------------------------------------------------- (Last) (First) (Middle) 311 Enterprise Drive -------------------------------------------------------------------------------- (Street) Plainsboro NJ 08536 -------------------------------------------------------------------------------- (City) (State) (Zip) Integra LifeSciences Holdings Corp. (IART) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol ________________________________________________________________________________ 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) 01/03/03 ________________________________________________________________________________ 4. Statement for Month/Day/Year ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) |_| Director |_| 10% Owner |X| Officer (give title below) |_| Other (specify below) Sr. Vice President, Operations ____________________________________________________________ ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable line) |X| Form Filed by One Reporting Person |_| Form Filed by More than One Reporting Person ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. Amount of 6. 4. Securities Owner- Securities Acquired (A) or Beneficially ship 2A. 3. Disposed of (D) Owned Form: 7. 2. Deemed Transaction (Instr. 3, 4 and 5) Following Direct Nature of Trans- Execution Code ------------------------------- Reported (D) or Indirect 1. action Date, if (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Date any ------------ or (Instr. 3 & (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V Amount (D) Price Instr.4) (Instr.4) (Instr.4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/13/02 I 949 A $15.0025 18,121 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. Number 10. of Owner- deriv- ship ative Form 2. Secur- of Conver- 5. 7. ities Deriv- 11. sion Number of Title and Amount Bene- ative Nature or Derivative 6. of Underlying 8. ficially Secur- of Exer- 3A. 4. Securities Date Securities Price Owned ity: In- cise Deemed Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Follow- Direct direct Price 3. Execut- action or Disposed Expiration Date ---------------- Deriv- ing (D) or Bene- 1. of Trans- ion Code of(D) (Month/Day/Year) Amount ative Reported In- ficial Title of Deriv- action Date if (Instr. (Instr. 3, ---------------- or Secur- Trans- direct Owner- Derivative ative Date any 8) 4 and 5) Date Expira- Number ity action(s) (I) ship Security Secur- (mm/dd/ (mm/dd/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity yy) yy) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Common Option $17.6500 12/31/02 A V 2,344 1 12/31/08 Stock 2,344 2,344 D ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Common Option $17.6500 12/31/02 A V 7,031 1 12/31/08 Stock 7,031 7,031 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: 1) 25% of the options vest one year after the grant date, with the remaining 75% vesting monthly thereafter over 36 months.
/s/ Don R. Nociolo 01/03/03 --------------------------------------------- ----------------------- **Signature of Reporting Person Date 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). ** 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 is insufficient, see Instruction 6 for procedure. Page 2