-----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, E5xpu9IVD7lux+qxEbz0K3sXMCSt5L2iiurTV0XBMIb0mM+6lYdbTWXHhNX/PRhZ 6J7LhSDNljrzrnzT1LoYuQ== 0000950149-01-500796.txt : 20010524 0000950149-01-500796.hdr.sgml : 20010524 ACCESSION NUMBER: 0000950149-01-500796 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010412 FILED AS OF DATE: 20010523 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CLAIMSNET COM INC CENTRAL INDEX KEY: 0001046057 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 752649230 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-14665 FILM NUMBER: 1646366 BUSINESS ADDRESS: STREET 1: 12801 N CENTRAL EXPRESSWAY STREET 2: SUITE 1515 CITY: DALLAS STATE: TX ZIP: 75243 BUSINESS PHONE: 9724581701 COMPANY DATA: COMPANY CONFORMED NAME: MCKESSON HBOC INC CENTRAL INDEX KEY: 0000927653 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-DRUGS PROPRIETARIES & DRUGGISTS' SUNDRIES [5122] OWNER IRS NUMBER: 943207296 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: ONE POST ST STREET 2: MCKESSON PLAZA CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 4159838300 MAIL ADDRESS: STREET 1: ONE POST ST CITY: SAN FRANCISCO STATE: CA ZIP: 94104 FORMER COMPANY: FORMER CONFORMED NAME: MCKESSON CORP DATE OF NAME CHANGE: 19950209 FORMER COMPANY: FORMER CONFORMED NAME: SP VENTURES INC DATE OF NAME CHANGE: 19940728 3 1 f72960be3.txt INITIAL STATEMENT OF BENEFICIAL OWNERSHIP 1 - -------- ------------------------------ FORM 3 OMB APPROVAL - -------- ------------------------------ OMB Number: 3235-0104 Expires: December 31, 2001 Estimated average burden hours per response ...... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date Statement Trading Symbol of Original McKesson HBOC, Inc. (Month/Day/Year) Claimsnet.com, Inc. ("CLAI") (Month/Day/Year) - ---------------------------------------- April 12, 2001 ---------------------------------- (Last) (First) (Middle) ---------------------------- 5. Relationship of Reporting ----------------------- 3. IRS or Social Security Person to Issuer 7. Individual or Joint/ One Post Street Number of Reporting (Check all applicable) Group Filing (Check - ---------------------------------------- Person (Voluntary) Director X 10% Owner applicable line) (Street) ----- ----- X Form filed by ---------------------------- Officer Other ----- One Reporting San Francisco, California 94104 ----- (give ----- (specify Person - -------------------------------------- title below) below) Form filed by (City) (State) (Zip) ----- More than One ---------------------------------- Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect (Instr. 4) Beneficially Owned Direct (D) or Beneficial (Instr. 4) Indirect (I) Ownership (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,514,285 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) *If the form is filed by more than one Reporting Person, see Instruction 5(b)(v). (Print or Type Responses)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect (Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership Expiration Date Derivative Security Exercise Form of (Instr. 5) (Month/Day/ (Instr. 4) Price of Deriv- Year) Deriv- ative ative Security: Security ------------------------------------------------- Direct Date Expira- Amount or (D) or Exercis- tion Title Number Indirect (I) able Date of Shares (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: McKesson HBOC, Inc. /s/ Ivan Meyerson May, 22, 2001 **Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------ ------------- Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Name: Ivan Meyerson Date Title: Senior Vice President, Note: File three copies of this form, one of which must be manually signed. General Counsel and If space provided is insufficient, See Instruction 6 for procedure. Corporate Secretary Potential persons who are to respond to the collection of information contained in this form Page 2 are not to respond unless the form displays a currently value OMB Number. SEC 1473 (9/96)
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