4 1 d4.txt FORM 4 =============================================================================== Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0287 / / Expires: January 31, 2005 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Roper William L. -------------------------------------------------------------------------------- (Last) (First) (Middle) 21250 Hawthorne Blvd. Suite 800 -------------------------------------------------------------------------------- (Street) Torrance CA 90503 -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Davita Inc. (DVA) ----------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) -------------- 4. Statement for Month/Year 08/2002 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director ___ Officer ___ 10% Owner ___ Other ----- (give title below) (specify below) ---------------------------------------------------------------- 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
------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature security action action or Disposed of (D) Securities ship of In- (Instr. 3) Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 03/31/2002 A(1) V 118 A $0.00 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 06/30/2002 A(2) V 211 A $0.00 598 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- Stock Options (Right to Buy) $25.22 04/11/2002 A(3) V 18,000 ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------------------------
Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of of In- Date ative Secur- Deriv- direct (Month/Day/ Secur- ities ative Bene- Year) ity Bene- Security: ficial (Instr. ficially Direct Owner- -------------------------------------------------- 5) Owned (D) or ship Date Expira- Amount or at End Indirect (Instr. Exer- tion Title Number of of (i) of 4) cisable Date Shares Month (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 04/11/2003(4) 04/11/2007 Common Stock 18,000 18,000 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: See attached page(s) 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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. /s/ William L. Roper 9/5/02 ------------------------------- ----------------- **Signature of Reporting Person Date Roper, William L. 21250 Hawthorne Boulevard, Suite 800 Torrance, CA 90803 DaVita Inc. (DVA) 08/2002 Name: Roper, William L. Statement for Month/Year: 08/2002 21250 Hawthorne Blvd., Suite 800 Issuer Name: DaVita Inc. (DVA) Torrance, CA 90503 -------------------------------------------------------------------------------- Note: 1 Grant of Restricted Units which will vest on March 31, 2003. Note: 2 Grant of Restricted Units which will vest on June 30, 2003. Note: 3 Nonqualified stock options granted under the First Amended and Restated 1997 Equity Compensation Plan. Note: 4 The option vests according to the following schedule: 7,333 shares on April 11, 2003. 7,333 shares on April 11, 2004 and 3,334 shares on April 11, 2005.