-----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, EusQX+KZcuw5VOKXNed8Bsaj+XlV57Vwe2DeOESkDDpH4zUM0hpN5TMaA07PJQKL a/XwP6bWDEFoxPha1QV2BQ== 0001089355-02-000650.txt : 20021206 0001089355-02-000650.hdr.sgml : 20021206 20021206125512 ACCESSION NUMBER: 0001089355-02-000650 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021202 FILED AS OF DATE: 20021206 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MIM CORP CENTRAL INDEX KEY: 0001014739 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 050489664 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28740 FILM NUMBER: 02850676 BUSINESS ADDRESS: STREET 1: 100 CLEARBROOK RD CITY: ELMSFORD STATE: NY ZIP: 10523 BUSINESS PHONE: 9147353555 MAIL ADDRESS: STREET 1: 25 NORTH ROAD CITY: PEACE DALE STATE: RI ZIP: 02883 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: CARFORA ALFRED CENTRAL INDEX KEY: 0000947959 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 63 COPPS HILL RD CITY: RIDGEFIELD STATE: CT ZIP: 06877 BUSINESS PHONE: 9144601627 MAIL ADDRESS: STREET 1: C/O MIM CORP STREET 2: 100 CLEARBROOK ROAD CITY: ELMSFORD STATE: NY ZIP: 10523 3 1 carforaform3mim8116.txt INITIAL STATEMENT OF BENEFICIAL OWNERSHIP U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Carfora Alfred - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o MIM Corporation 100 Clearbrook Road - -------------------------------------------------------------------------------- (Street) Elmsford NY 10523 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Date of Event Requiring Statement (Month/Day/Year) December 2, 2002 - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol MIM Corporation (MIMS) - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [_] Other (specify below) President and Chief Operating Officer - -------------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (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 ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.0001 par value -0- - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print of Type Responses) (Over) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ Alfred Carfora December 6, 2002 - --------------------------------------------- ----------------------- **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). Page 2 -----END PRIVACY-ENHANCED MESSAGE-----