-----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, WwIZBtzh1F1oof431JfINoawcMN6mihsi5KNhVbGKujTaw6xz+Cv6JkoNhiHiu20 U3PcLOBzXzGY3NbUDiFzEg== 0000920527-04-000087.txt : 20041117 0000920527-04-000087.hdr.sgml : 20041117 20041117082918 ACCESSION NUMBER: 0000920527-04-000087 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041115 FILED AS OF DATE: 20041117 DATE AS OF CHANGE: 20041117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RAMSEY DAVID H CENTRAL INDEX KEY: 0001183756 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23832 FILM NUMBER: 041150847 BUSINESS ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD. CITY: JACKSONVILLE STATE: FL ZIP: 32216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PSS WORLD MEDICAL INC CENTRAL INDEX KEY: 0000920527 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 592280364 STATE OF INCORPORATION: FL FISCAL YEAR END: 0329 BUSINESS ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 BUSINESS PHONE: 9043323000 MAIL ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 FORMER COMPANY: FORMER CONFORMED NAME: PHYSICIAN SALES & SERVICE INC /FL/ DATE OF NAME CHANGE: 19940318 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-11-15 0000920527 PSS WORLD MEDICAL INC PSSI 0001183756 RAMSEY DAVID H 3715 PINCKNEY ISLAND CT. JACKSONVILLE FL 32224 0 1 0 0 V.P. Chief Information Officer Common Stock 2004-11-15 4 M 0 5000 6.06 A 7550 D Common Stock 2004-11-15 4 M 0 5000 7.40 A 12550 D Common Stock 2004-11-15 4 S 0 10000 12.373 D 2550 D Common Stock 232 I by Spouse in 401(k) Plan Non Qualified Stock Option (right to buy) 6.06 2004-11-15 4 M 0 5000 0 D 2002-07-25 2006-07-25 Common Stock 5000 0 D Non Qualified Stock Option (right to buy) 7.40 2004-11-15 4 M 0 5000 0 D 2003-08-21 2007-08-21 Common Stock 5000 5000 D 401(k) - PSS World Medical, Inc. 401(k) Savings Plan Shares were calculated by taking the balance of the Stock Fund on 11/15/04 and dividing by the closing price on 11/15/04. $2,914.15 / 12.53 = 232 shares. The option vested in three equal annual installments on July 25, 2002, July 25, 2003 and July 25, 2004. The option vests in three equal annual installments on August 21, 2003, August 21, 2004 and August 21, 2005. Mark Rotondaro, attorney-in-fact 2004-11-17 -----END PRIVACY-ENHANCED MESSAGE-----