-----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, LJfojC/cVl/ZddnpymMYKl4TMKs6ztGkHmGDAzfMX+toP3YVdeOPHQhI0pHVgZ6F f/au2t3D+bNM/fwrlRlCaA== 0001047469-98-006637.txt : 19980218 0001047469-98-006637.hdr.sgml : 19980218 ACCESSION NUMBER: 0001047469-98-006637 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980217 SROS: NONE 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: SEC FILE NUMBER: 005-49805 FILM NUMBER: 98543181 BUSINESS ADDRESS: STREET 1: 199 JEFFERSON DR CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 4154733100 MAIL ADDRESS: STREET 1: 199 JEFFERSON DR CITY: MENLO PARK STATE: CA ZIP: 94025 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 SCHEDULE 13-G/A#2 OMB APPROVAL -------------------------- OMB Number: 3235-0145 Expires: December 31, 1997 Estimated average burden hours per response.. 14.90 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. TWO)* Perclose, Inc. ---------------------------------------- (NAME OF ISSUER) Common Stock, $0.001 par value per share ---------------------------------------- (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 of 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 cover 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). Page 1 of 5 Pages CUSIP NO. 71361C 10 7 13G PAGE 2 OF 5 PAGES ----------- --- --- - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON John B. Simpson, M.D., Ph.D. - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) / / (b) / / - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A. - ------------------------------------------------------------------------------- 5 SOLE VOTING POWER 70,745 -------------------------------------------------- 6 SHARED VOTING POWER NUMBER OF SHARES BENEFICIALLY 1,843,237 OWNED BY EACH -------------------------------------------------- REPORTING PERSON 7 SOLE DISPOSITIVE POWER WITH 70,745 -------------------------------------------------- 8 SHARED DISPOSITIVE POWER 1,843,237 - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,913,982 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 17.9% (based on 10,669,312 shares of Common Stock outstanding as of December 31, 1997 - ------------------------------------------------------------------------------- 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. (b) Address of Issuer's Principal Executive Offices 199 Jefferson Drive, Menlo Park, CA 94025 ITEM 2. (a) Name of Person Filing John B. Simpson, M.D., Ph.D. (b) Address of Principal Business Office or, if none, Residence 309 Manuella Road, Woodside, CA 95063 (c) Citizenship United States (d) Title of Class of Securities Common Stock, $0.001 par value per share (e) CUSIP Number 71361C 10 7 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b), OR 13d-2(b), CHECK WHETHER THE PERSON 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 Section 240.13d-1(b)(1)(ii)(F) (g) / / Parent Holding Company, in accordance with Section 240.13d-1(b)(ii)(G) (Note: See Item 7) (h) / / Group, in accordance with Section 240.13d-1(b)(1)(ii)(H) N/A -- The reporting 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 1,913,982 (b) Percent of Class 17.9% (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote 70,745 (ii) shared power to vote or to direct the vote 1,843,237 (iii) sole power to dispose or direct the disposition of 70,745 (iv) shared power to dispose or direct the disposition of 1,843,237
* Consists of (i) 1,298,943 shares held by the Simpson Family Trust over which Dr. Simpson and his wife hold voting and dispositive control, (ii) 396,294 shares held by Fox Hollow, Ltd., of which Dr. Simpson is a general partner, (iii) 49,600 shares held by Dr. Simpson as Custodian for John David Simpson over which Dr. Simpson holds voting and dispositive control, (iv) 21,145 shares subject to outstanding vested options within 60 days after December 31, 1997 and (v) an aggregate of 148,000 shares held in trust for the benefit of three of Dr. Simpson's adult children over which Dr. Simpson, as a trustee, shares voting and dispositive control. 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 / / . ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not Applicable ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not Applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP Not Applicable ITEM 9. NOTICE OF DISSOLUTION OF GROUP Not Applicable CUSIP No. 71361C 10 7 13G Page 5 of 5 Pages ITEM 10. 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 17, 1998 ---------------------------------------- Date /s/ Garrett C. McGonigal ---------------------------------------- Signature Garrett C. McGonigal, Attorney-in-Fact ---------------------------------------- Name/Title
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