-----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, Wf3a9OQOxZaXpIMfJC26dtWGs7qwaUBfIq3QUoTcEJ/uc/tRB5XQ+YLA0JYlfRZ/ ZInd3RyPFFqssOaSbHwCZg== 0000935836-00-000212.txt : 20000421 0000935836-00-000212.hdr.sgml : 20000421 ACCESSION NUMBER: 0000935836-00-000212 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991112 FILED AS OF DATE: 20000420 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: VIDAMED INC CENTRAL INDEX KEY: 0000929900 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 770314454 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-26082 FILM NUMBER: 605464 BUSINESS ADDRESS: STREET 1: 46107 LANDING PARKWAY STREET 2: SUITE 101 CITY: FREMONT STATE: CA ZIP: 94538 BUSINESS PHONE: 5104924900 MAIL ADDRESS: STREET 1: 46107 LANDING PARKWAY STREET 2: STE 101 CITY: FREMONT STATE: CA ZIP: 94538 COMPANY DATA: COMPANY CONFORMED NAME: VIDAMED INC CENTRAL INDEX KEY: 0000929900 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] OFFICER IRS NUMBER: 770314454 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 46107 LANDING PARKWAY STREET 2: SUITE 101 CITY: FREMONT STATE: CA ZIP: 94538 BUSINESS PHONE: 5104924900 MAIL ADDRESS: STREET 1: 46107 LANDING PARKWAY STREET 2: STE 101 CITY: FREMONT STATE: CA ZIP: 94538 3 1 OMB Number 3235-0104 Expires: September 30, 1998 Estimated average burden hours per response 0.5 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D. C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP 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 (Print or Type Responses) 1. Name and Address of Reporting Person LaPlante, Paulita, 7615 Golden Triangle Dr., Suite C, Minneapolis, MN 55344 (Last), (First) (Middle), (Street), (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year): 11/12/99 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol: VidaMed, Inc. (VIDA) 5. Relationship of reporting person to issuer (Check all applicable) _XX_ Director ____ 10% Owner ____ Officer (give ____ Other (specify title below) below) ______________________ 6. If Amendment, Date of Original (Month/Day/Year) _______________ 7. Individual or Joint/Group Filing (Check Applicable line) _XX_ Form filed by one Reporting Person ____ Form filed by More than One Reporting Person FORM 3 (continued) Page 2 of 3 Pages Table I - Non-Derivative Securities Beneficially Owned 1. Title of Security: No Securities Owned 2. Amount of Securities Beneficially Owned (Instr. 4): ____________ 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5): _________ 4. Nature of Indirect Beneficial Ownership (Instr. 5): ____________________________________________________________ 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). SEC 1473 (7-96) FORM 3 (continued) Page 3 of 3 Pages Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security: _______________ 2. Date Exercisable and Expiration Date (Month/Day/Year) Date Exercisable Expiration Date ____________________ ___________________ 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4): Title: __________________ Amount or Number of Shares: _________ 4. Conversion or Exercise Price of Derivative Security: _______________ 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5): ________________ 6. Nature of Indirect Beneficial Ownership (Instr. 5) __________________________________________________________________ Explanation of Responses: /s/ Paulita LaPlante 4/17/00 **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 Number. CRK\5402\002\1096482.01 4/19/2000 4:50 -----END PRIVACY-ENHANCED MESSAGE-----