-----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, IXuGsH/2ySouyYlO2YV1+19wjQY8WvXdr4MD76RwwU1wMg7hpvxSFXvTtADf4X+Q faHgec3ZVm2v1v1MHBkkfQ== 0001021408-02-001516.txt : 20020414 0001021408-02-001516.hdr.sgml : 20020414 ACCESSION NUMBER: 0001021408-02-001516 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020208 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: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26082 FILM NUMBER: 02530470 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: 5 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 5 1 d5.txt FORM 5 FOR JOHN P. HOWE /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ UNITED STATES | FORM 5 | SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL 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 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Howe John F. ---------------------------------------------------------------------------- (Last) (First) (Middle) 46107 Landing Parkway ---------------------------------------------------------------------------- (Street) Fremont CA 94538 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol VidaMed, Inc. (VIDA) ----------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) ----------------------------------------------------------------- 4. Statement for Month/Year 2001 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [_] Director [X] Officer [_] 10% Owner [_] Other (give title below) (specify below) Vice President Finance & Chief Financial Officer ------------------------------------------------ 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 Acquired, Disposed of, or Beneficially Owned
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) Owned at Direct Bene- Day/ End of (D) or ficial Year) ------------------------- Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 25,960 (1) D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
FORM 5 (continued) Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) FORM 5 (continued)
- ---------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conversion 3. Trans- 4. Trans- 5. Number of Security (Instr. 3) or Exercise action action Derivative Price of Date Code Securities Derivative (Month/ (Instr. 8) Acquired (A) or Security Day/ Disposed of (D) Year) (Instr. 3, 4, and 5) --------------------- (A) (D) - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- Employee Stock Option $4.375 2/15/01 A 15,048 (right to buy) - ---------------------------------------------------------------------------------------------------------------------- Employee Stock Option $4.375 2/15/01 A 44,952 (right to buy) - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ 6. Date 7. Title and Amount of 8. Price of 9. Number of 10. Owner- 11. Nature of Exercisable Underlying Derivative Derivative ship of Indirect and Securities Security Securities Deriva- Beneficial Expiration (Instr. 3 and 4) (Instr. 5) Beneficially tive Owner- Date Owned at Security: ship (Instr. (Month/ End of Direct 4) Day/Year) Year (D) ---------------------------------------------------------- (Instr. 4) or Indirect Date Expi- Title Amount or (1) Exer- ration Number of (Instr. 4) cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ (2) 2/15/11 Common 15,048 15,048 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ (2) 2/15/11 Common 44,952 44,952 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Includes 21,000 shares as was indicated on Form 5 for year ended 12/31/00, 12,500 shares purchased in 2001 under the Employee Stock Purchase Plan of which 7,540 were sold on December 13, 2001 and reported on From 4. (2) One-fourth vests on 2/15/02 and 1/48th per month thereafter until fully exercisable /s/ John F. Howe 1/22/02 ------------------------------------- ------------ ** Intentional misstatements or omissions of facts constitute Federal Criminal **Signature of Reporting Person Date 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. -----END PRIVACY-ENHANCED MESSAGE-----