-----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, GCBAVQ4BZ98fusASxfqhp3uRsnhUf1uGje+5R59GKkkfG2yqfB1zM3PW5E2fVOUh Xy+H0/nYmkch2RKyCCCmkQ== 0000912057-97-006497.txt : 19970225 0000912057-97-006497.hdr.sgml : 19970225 ACCESSION NUMBER: 0000912057-97-006497 CONFORMED SUBMISSION TYPE: SC 13G/A CONFIRMING COPY: PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970224 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PERCLOSE INC CENTRAL INDEX KEY: 0000934438 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 943154669 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-49805 FILM NUMBER: 00000000 BUSINESS ADDRESS: STREET 1: 199 JEFFERSON DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 4154733100 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SIMPSON JOHN B PH D MD CENTRAL INDEX KEY: 0001007708 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 309 MANUELLA ROAD CITY: WOODSIDE STATE: CA ZIP: 95062 BUSINESS PHONE: 4158519470 MAIL ADDRESS: STREET 1: 309 MANUELLLA ROAD CITY: WOODSIDE STATE: CA ZIP: 95063 SC 13G/A 1 SC 13G/A THIS DOCUMENT IS A COPY OF THE 13G/A PREVIOUSLY FILED ON FEBRUARY 18, 1997 PURSUANT TO A RULE 201 TEMPORARY HARDSHIP EXEMPTION. UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. One)* Perclose, Inc. ---------------------------------- (Name of Issuer) Common Stock ---------------------------------- (Title of Class of Securities) 71361C 10 7 ---------------------------------- (CUSIP Number) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (Continued on following page(s)) Page 1 of 5 Pages --- CUSIP No. 71361C 10 7 13G Page 2 of 5 Pages --------- --- --- - ------------------------------------------------------------------------------- (1) Names of Reporting Persons. S.S. or I.R.S. Identification Nos. of Above Persons John B. Simpson, M.D., Ph.D. - ------------------------------------------------------------------------------- (2) Check the Appropriate Box if a Member (a) / / of a Group* (b) / / - ------------------------------------------------------------------------------- (3) SEC Use Only - ------------------------------------------------------------------------------- (4) Citizenship or Place of Organization United States - ------------------------------------------------------------------------------- Number of Shares (5) Sole Voting Power Beneficially 50,000 Owned by -------------------------------------------------- Each Reporting (6) Shared Voting Power Person With 1,828,144 -------------------------------------------------- (7) Sole Dispositive Power 50,000 -------------------------------------------------- (8) Shared Dispositive Power 1,828,144 - ------------------------------------------------------------------------------- (9) Aggregate Amount Beneficially Owned by Each Reporting Person 1,878,144 - ------------------------------------------------------------------------------- (10) Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares* Excludes an aggregate of 150,000 shares (see Item 4) - ------------------------------------------------------------------------------- (11) Percent of Class Represented by Amount in Row (9) 19.7% - ------------------------------------------------------------------------------- (12) Type of Reporting Person* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! CUSIP No. 71361C 10 7 13G Page 3 of 5 Pages --------- --- --- ITEM 1(A). NAME OF ISSUER Perclose, Inc. - ------------------------------------------------------------------------------- ITEM 1(B). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES 199 Jefferson Drive Menlo Park, CA 94025 - ------------------------------------------------------------------------------- ITEM 2(A). NAME OF PERSON(S) FILING John B. Simpson, M.D., Ph.D. - ------------------------------------------------------------------------------- ITEM 2(B). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE 309 Manuella Road Woodside, CA 95062 USA - ------------------------------------------------------------------------------- ITEM 2(C). CITIZENSHIP USA - ------------------------------------------------------------------------------- ITEM 2(D). TITLE OF CLASS OF SECURITIES Common Stock - ------------------------------------------------------------------------------- ITEM 2(E). CUSIP NUMBER 71361C 10 7 - ------------------------------------------------------------------------------- ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(B), OR 13D-2(B), CHECK WHETHER THE PERSON FILING IS A (a) / / Broker or Dealer registered under Section 15 of the Act (b) / / Bank as defined in section 3(a)(6) of the Act (c) / / Insurance Company as defined in section 3(a)(19) of the Act (d) / / Investment Company registered under section 8 of the Investment Company Act (e) / / Investment Adviser registered under section 203 of the Investment Advisers Act of 1940 (f) / / Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see Rule 13d-1(b)(1)(ii)(F) (g) / / Parent Holding Company, in accordance with Rule 13d-1(b)(ii)(G) (Note: See Item 7) (h) / / Group, in accordance with Rule 13d-1(b)(1)(ii)(H) N/A The filing person acquired all its shares prior to the registration of the Issuer's shares pursuant to Section 12 of the Securities Exchange Act of 1934, as amended; therefore, this filing is pursuant to Rule 13d-1(c). CUSIP No. 71361C 10 7 13G Page 4 of 5 Pages --------- --- --- ITEM 4. OWNERSHIP (a) Amount Beneficially Owned: 1,878,144* ---------- * Consists of (i) 1,391,850 shares held by the Simpson Family Trust over which Dr. Simpson and his wife hold voting and dispositive control, (ii) 436,294 shares held by Fox Hollow, Ltd., of which Dr. Simpson is a general partner and (iii) 50,000 shares held by Dr. Simpson as Custodian for John David Simpson over which Dr. Simpson holds voting and dispositive control. Does not include an aggregate of 150,000 shares issued to three of Dr. Simpson's adult children over which Dr. Simpson does not hold voting or dispositive control. --------------------------------------------------------------------------- (b) Percent of Class: 19.7% (based on 9,530,471 shares outstanding as of 12/31/96) --------------------------------------------------------------------------- (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote 50,000 ----------------------------------------------------------------- (ii) shared power to vote or to direct the vote 1,828,144 ----------------------------------------------------------------- (iii) sole power to dispose or to direct the disposition of 50,000 ----------------------------------------------------------------- (iv) shared power to dispose or to direct the disposition of 1,828,144 ----------------------------------------------------------------- ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following. / / N/A ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON N/A - ------------------------------------------------------------------------------- ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY N/A - ------------------------------------------------------------------------------- ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP N/A - ------------------------------------------------------------------------------- ITEM 9. NOTICE OF DISSOLUTION OF GROUP N/A - ------------------------------------------------------------------------------- CUSIP No. 71361C 10 7 13G Page 5 of 5 Pages --------- --- --- ITEM 10. CERTIFICATION By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or as a participant in any transaction having such purposes or effect. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 11, 1997 ---------------------------------------- (Date) /s/ John B. Simpson, M.D., Ph.D. ---------------------------------------- (Signature) John B. Simpson, M.D., Ph.D. ---------------------------------------- (Name/Title) -----END PRIVACY-ENHANCED MESSAGE-----