SEC Form 3
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*
PARKINSON ROBERT L JR

(Last) (First) (Middle)
ONE BAXTER PARKWAY

(Street)
DEERFIELD, IL 60015

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/26/2004
3. Issuer Name and Ticker or Trading Symbol
BAXTER INTERNATIONAL INC [ BAX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman of the Board and
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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
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, $1 par value 10,000 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Stock Option (right to buy) 04/19/2007 04/18/2014 Common Stock, $1 par value 650,000 $31.72 D
Equity Unit (obligation to buy)(1) 02/16/2006(1) 02/16/2006(1) Common Stock, $1 par value (1) $50 D
Explanation of Responses:
1. Reporting person owns 85 Equity Units. Each Equity Unit consists of $50 principal amount of senior notes due February 16, 2008 and a purchase contract obligating the holder to purchase and the company to sell, at a price of $50 in cash per unit, a variable number of shares of Baxter International Inc. common stock ("Common Stock") on February 16, 2006, calculated as follows: if the "applicable market value" (defined as the average closing price per share of Common Stock during the 20 consecutive trading days ending on the third trading day immediately preceding February 16, 2006) of a share of Common Stock is equal to or less than $28.78, 1.7373 shares per unit will be delivered; if the applicable market value is between $28.78 and $35.69, shares equal to $50 divided by the applicable market value will be delivered for each unit; if the applicable market value is equal to or greater than $35.69, 1.4011 shares per unit will be delivered.
Remarks:
Reporting person may settle the purchase contract early by paying $50 cash per unit, in which case 1.4011 shares per unit will be delivered.
Robert L. Parkinson, Jr. 04/27/2004
** 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.