3 1 0001.txt FORM 3 FOR LEWIS CHAPMAN
+--------+ ---------------------------- | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL +--------+ WASHINGTON, D.C. 20549 ---------------------------- OMB Number: 3235-0104 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Expires: September 30, 1998 Estimated average burden Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, hours per response...... 0.5 Section 17(a) of the Public Utility Holding Company Act of 1935 or ---------------------------- Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Chapman Lewis P. ---------------------------------------------------------------------------- (Last) (First) (Middle) 46107 Landing Parkway ---------------------------------------------------------------------------- (Street) Fremont CA 94538 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 2/08/01 -------------- 3. IRS Identification Number of Reporting Person, if an entity (voluntary) ---------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol VidaMed, Inc. (VIDA) ----------------------------------- 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [X] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) Vice President of Sales & Marketing ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- 7. Individual or Joint/Group Reporting (Check applicable line) [X] Form Filed by One Reporting Person [ ] Form Filed by More than One Reporting Person TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- No Securities Owned -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- --------------------------------------------------------------------------------
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 5(b)(v). 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 control number. (over) FORM 3 (continued) TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Lewis P. Chapman 2/12/01 ------------------------------- ----------------- **Signature of Reporting Person Date **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 control number. Page 2