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)