-----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, EwNDCSvCQTi4hsS1bHoEAs3ndDY/ssB6UsCexIeTeMyxF8L+nssy3AnoLfkJDa7w gez9CJ+L/QJ1Er9U500hkw== 0000009892-03-000022.txt : 20030204 0000009892-03-000022.hdr.sgml : 20030204 20030204132018 ACCESSION NUMBER: 0000009892-03-000022 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021201 FILED AS OF DATE: 20030204 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: GROM CHARLES P CENTRAL INDEX KEY: 0001205053 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O C R BARD INC STREET 2: 730 CENTRAL AVENUE CITY: MURRAY HILL STATE: NJ ZIP: 07974 BUSINESS PHONE: 908 277 8000 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BARD C R INC /NJ/ CENTRAL INDEX KEY: 0000009892 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 221454160 STATE OF INCORPORATION: NJ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-06926 FILM NUMBER: 03538024 BUSINESS ADDRESS: STREET 1: 730 CENTRAL AVE CITY: MURRAY HILL STATE: NJ ZIP: 07974 BUSINESS PHONE: 9082778000 MAIL ADDRESS: STREET 1: 730 CENTRAL AVENUE CITY: MURRAY HILL STATE: NJ ZIP: 07974 5 1 edgar.txt FORM 5 - 12-01-2002 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). ( ) Form 3 Holdings Reported ( ) Form 4 Transactions Reported 1. Name and Address of Reporting Person Charles P. Grom C. R. Bard, Inc. 730 Central Avenue NJ, Murray Hill 07974 2. Issuer Name and Ticker or Trading Symbol C. R. Bard, Inc. (BCR) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 12/2002 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Vice President and Controller 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. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | |Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership | |Date |Code| | Beneficially |(D)or | | | | | | A/| | Owned at |Indir | | | | | Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock | | | | | |7810 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |2561.99996 1 |I |401 (k) Plan | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |22.66 2 |I |By Son 3 | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity | | | Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Option (Right to Buy) 4 |54.435 |3/1/ |A |10000 |A |5 |03/01|Common Stock|10000 | |20000 |D | | | |2002 | | | | |/2012| | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option (Right to Buy) 4 |52.025 |7/10/|A |5000 |A |6 |07/10|Common Stock|5000 | |10000 |D | | | | 2002| | | | |/2012| | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: 1. Includes total purchases of 119 shares in 2002 under the Employees Retirement Savings Plan. 2. Includes .43 shares purchased in 2002 under the Company's Dividend Reinvestment Plan. 3. The reporting person disclaims beneficial ownership. 4. Performance options granted under 1993 Long Term Incentive Plan of C. R. Bard, Inc. Also granted in tandem with these options are Limited Stock Appreciation Rights which can only be exercised upon a "Change of Control" as defined in the Plan. 5. Options vest in accordance with schedule upon achievement of certain performance criteria or fully vest in seven years. 6. Options vest in accordance with schedule upon achievement of certain performance criteria or fully vest in five years. SIGNATURE OF REPORTING PERSON Charles P. Grom Attorney-in-Fact -----END PRIVACY-ENHANCED MESSAGE-----