FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 11/19/2015 |
3. Issuer Name and Ticker or Trading Symbol
LIBERATOR MEDICAL HOLDINGS, INC. [ LBMH ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 0(1)(2)(3) | I | See Explanation of Responses |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. C. R. Bard, Inc. (the "Reporting Person") is filing this statement solely because, as a result of a Voting and Support Agreement, dated as of November 19, 2015, among the Reporting Person, Liberator Medical Holdings, Inc. (the "Issuer"), and certain holders of the Issuer's Common Stock (collectively, the "Stockholders"), the Reporting Person may be deemed to have beneficial ownership of shares of common stock, $0.001 par value, of the Issuer ("Common Stock") beneficially owned by the Stockholders. The Voting Agreement was entered into in connection with the Agreement and Plan of Merger, dated as of November 19, 2015, among the Reporting Person, the Issuer and Freedom MergerSub, Inc., a wholly owned subsidiary of the Reporting Person. |
2. Neither the filing of this statement nor any of its contents shall be deemed to constitute an admission by the Reporting Person that it is the beneficial owner of any Common Stock referred to herein for purposes of Section 16 of the Securities and Exchange Act of 1934, as amended (the "Act"). The Reporting Person has no pecuniary interest in such Common Stock. The Reporting Person, pursuant to Rule 16a-1(a)(4) promulgated under the Act, hereby expressly disclaims that it is the beneficial owner of such Common Stock. |
3. No securities are beneficially owned. |
Remarks: |
/s/ Richard C. Rosenzweig | 11/24/2015 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal 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 is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |