-----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, JisMa0fQTj4deYovam9bKLnG0TTfLFSHVqoTHySk602X4GZytyiTsRM6aSYK/x9O gZH63lEPctxSyrsb8d/uwA== 0000897464-00-000007.txt : 20000509 0000897464-00-000007.hdr.sgml : 20000509 ACCESSION NUMBER: 0000897464-00-000007 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20000508 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PATIENT INFOSYSTEMS INC CENTRAL INDEX KEY: 0001017813 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 161476509 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: SEC FILE NUMBER: 005-50085 FILM NUMBER: 621513 BUSINESS ADDRESS: STREET 1: 46 PRINCE ST CITY: ROCHESTER STATE: NY ZIP: 14607 BUSINESS PHONE: 7162427200 MAIL ADDRESS: STREET 1: 46 PRINCE ST CITY: ROCHESTER STATE: NY ZIP: 14607 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: PAPPAJOHN JOHN CENTRAL INDEX KEY: 0000897464 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: C/O EQUITY DYNAMICS STREET 2: 2116 FINANCIAL CENTER CITY: DES MOINES STATE: IA ZIP: 50309 MAIL ADDRESS: STREET 1: 2116 FINANCIAL CENTER STREET 2: C/O EQUITY DYNAMICS CITY: DES MOINES STATE: IA ZIP: 50309 SC 13D/A 1 13D UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D Under the Securities Exchange Act of 1934 Amendment No. 1 PATIENT INFOSYSTEMS, INC. (Name of Issuer) Common Stock $.01 Par Value Per Share (Title Class of Securities) 878190115 (CUSIP Number) Mr. John Pappajohn 2116 Financial Center Des Moines, Iowa 50309 515-244-5746 (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) March 31, 2000 (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(b)(3) or (4), check the following box: / / Check the following box if a fee is being paid with this statement: / / (1) NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON John Pappajohn ###-##-#### (2) CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) / / (b) / / (3) SEC USE ONLY (4) SOURCE OF FUNDS PF (5) CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e) / / (6) CITIZENSHIP OR PLACE OR ORGANIZATION U.S.A. NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH: (7) SOLE VOTING POWER 2,313,780 (8) SHARED VOTING POWER 0 (9) SOLE DISPOSITIVE POWER 2,313,780 (10) SHARED DISPOSITIVE POWER 0 (11) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 2,313,780 (12) CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES / / (13) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 11 26.32% (14) TYPE OF REPORTING PERSON IN SCHEDULE 13D This amends and supplements the Statement on Schedule 13D filed with the Commission by John Pappajohn ("Pappajohn") with respect to his ownership of Common Stock (the "Common Stock"), $.01 par value per share, Convertible Preferred Stock, Series C, no par value per share ("Series C Preferred Stock"), Warrants to purchase shares of Common Stock (the "Warrants") and Options to purchase shares of Common Stock (the "Options") of Patient Infosystems, Inc., a Delaware Corporation (the "Company"). Unless otherwise defined herein, all capitalized items used herein shall have the meaning ascribed to them in the Statement. Item 5. Interest in Securities of the Issuer (a) As of the date of this statement, Mr. Pappajohn beneficially owned 1,972,480 shares of Common Stock (assuming the conversion of 50,000 shares of Series C Preferred Stock into 400,000 shares of Common Stock) and Warrants and Options to purchase another 341,300 shares of Common Stock. Such shares of Common Stock and the Warrants and Options represent 26.32% of the Company's issued and outstanding shares, assuming conversion of Pappajohn's Series C Preferred Stock, Warrants, and Options into Common Stock. This does not include 7,200 shares subject to outstanding Options which are not exercisable within the next 60 days. (b) Mr. Pappajohn has sole power to vote or direct the vote and sole power to dispose or direct the disposition of all shares of Common Stock and Series C Preferred Stock that he owns. (b) On March 31, 2000, Mr. Pappajohn purchased 50,000 shares of Series C Preferred Stock for $500,000. The shares of Series C Preferred Stock are convertible into 400,000 shares of Common Stock. In addition, Mr. Pappajohn was granted Warrants to purchase 187,500 and 125,000 shares of Common Stock on February 16, 2000 and March 23, 2000, respectively, in consideration of a personal guarantee on the Company's Line of Credit. (d - e) Not applicable. Item 6. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of Issuer Not applicable. Item 7. Material to be Filed as Exhibits Not applicable. Item 8. Certification and Signature: After reasonable inquiry and to the best of my knowledge and belief, the undersigned certifies that the information set forth in this Statement is true, complete and correct. Dated: May 8, 2000 /s/ John Pappajohn - ------------------- John Pappajohn -----END PRIVACY-ENHANCED MESSAGE-----