SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
JEWETT ROBERT W

(Last) (First) (Middle)
53 MADISON AVE

(Street)
FLEMINGTON NJ 08822

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
HOOPER HOLMES INC [ HH ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Senior Vice President, General
3. Date of Earliest Transaction (Month/Day/Year)
08/03/1988
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 09/13/1996 M 42,000(1) A $0.6875 42,000 D
Common Stock 09/13/1996 S 42,000 D $1.78 0 D
Common Stock 10/23/1997 M 51,000 A $1.5781 51,000 D
Common Stock 10/23/1997 M 60,000 A $1.75 111,000 D
Common Stock 10/23/1997 M 36,000 A $1.8675 147,000 D
Common Stock 10/23/1997 S 51,000 D $3.5 96,000 D
Common Stock 10/23/1997 S 60,000 D $3.5 36,000 D
Common Stock 10/23/1997 S 36,000 D $3.5 0 D
Common Stock 11/25/1997 M 17,000 A $1.5781 17,000 D
Common Stock 11/25/1997 S 17,000 D $3.78 0 D
Common Stock 05/05/1998 M 25,600 A $1.4844 25,600 D
Common Stock 05/05/1998 S 25,600 D $6.25 0 D
Common Stock 05/06/1998 M 5,600 A $1.4844 5,600 D
Common Stock 05/06/1998 M 12,000 A $1.8675 17,600 D
Common Stock 05/06/1998 S 5,600 D $6.25 12,000 D
Common Stock 05/06/1998 S 12,000 D $6.25 0 D
Common Stock 05/05/1999 M 8,000 A $1.4844 8,000 D
Common Stock 05/05/1999 S 8,000 D $8.517 0 D
Common Stock 05/06/1999 M 2,000 A $1.4844 2,000 D
Common Stock 05/06/1999 S 2,000 D $8.5 0 D
Common Stock 05/07/1999 M 2,000 A $0.9844 2,000 D
Common Stock 05/07/1999 M 19,600 A $0.9844 21,600 D
Common Stock 05/07/1999 M 400 A $1.4844 22,000 D
Common Stock 05/07/1999 S 19,600 D $8.5 2,400 D
Common Stock 05/07/1999 S 400 D $8.5 2,000 D
Common Stock 05/07/1999 S 2,000 D $8.5315 0 D
Common Stock 09/02/1999 M 24,600 A $0.9844 24,600 D
Common Stock 09/02/1999 S 24,600 D $11.8125 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options (Right to buy) $0.6875 08/03/1988 A 42,000(1) 08/03/1990 08/03/1998 Common Stock 42,000 $0.6875 42,000 D
Stock Options (Right to buy) $1.75 01/07/1992 A 60,000 01/07/1994 01/07/2002 Common Stock 60,000 $1.75 60,000 D
Stock Options (Right to buy) $1.5781 10/28/1992 A 68,000 10/28/1994 10/28/2002 Common Stock 68,000 $1.5781 68,000 D
Stock Options (Right to buy) $1.8675 04/09/1993 A 48,000 04/09/1995 04/09/2003 Common Stock 48,000 $1.8675 48,000 D
Stock Options (Right to buy) $1.4844 01/25/1994 A 41,600 01/25/1996 01/25/2004 Common Stock 41,600 $1.4844 41,600 D
Stock Options (Right to buy) $0.9844 01/24/1995 A 61,600 01/24/1997 01/24/2005 Common Stock 61,600 $0.9844 61,600 D
Stock Options (Right to buy) $1 11/20/1995 A 60,000 11/20/1997 11/20/2005 Common Stock 60,000 $1 60,000 D
Stock Options (Right to buy) $0.6875 09/13/1996 M 42,000 08/03/1990 08/03/1998 Common Stock 42,000 $0.6875 0 D
Stock Options (Right to buy) $2.0313 01/28/1997 A 64,000 01/28/1999 01/28/2007 Common Stock 64,000 $2.0313 64,000 D
Stock Options (Right to buy) $1.5781 10/23/1997 M 51,000 10/28/1994 10/28/2002 Common Stock 51,000 $1.5781 17,000 D
Stock Options (Right to buy) $1.75 10/23/1997 M 60,000 01/07/1994 01/07/2002 Common Stock 60,000 $1.75 0 D
Stock Options (Right to buy) $1.8675 10/23/1997 M 36,000 04/09/1995 04/09/2003 Common Stock 36,000 $1.8675 12,000 D
Stock Options (Right to buy) $1.5781 11/25/1997 M 17,000 10/28/1994 10/28/2002 Common Stock 17,000 $1.5781 0 D
Stock Options (Right to buy) $3.6875 02/06/1998 A 20,000 02/06/2000 02/06/2008 Common Stock 20,000 $3.6875 20,000 D
Stock Options (Right to buy) $1.4844 05/05/1998 M 25,600 01/25/1996 01/25/2004 Common Stock 25,600 $1.4844 16,000 D
Stock Options (Right to buy) $1.4844 05/06/1998 M 5,600 01/25/1996 01/25/2004 Common Stock 5,600 $1.4844 10,400 D
Stock Options (Right to buy) $1.8675 05/06/1998 M 12,000 04/09/1995 04/09/2003 Common Stock 12,000 $1.8675 0 D
Stock Options (Right to buy) $6.6875 12/21/1998 A 40,000 12/21/2000 12/21/2008 Common Stock 40,000 $6.6875 40,000 D
Stock Options (Right to buy) $1.4844 05/05/1999 M 8,000 01/25/1996 01/25/2004 Common Stock 8,000 $1.4844 2,400 D
Stock Options (Right to buy) $1.4844 05/06/1999 M 2,000 01/25/1996 01/25/2004 Common Stock 2,000 $1.4844 400 D
Stock Options (Right to buy) $0.9844 05/07/1999 M 2,000 01/24/1997 01/24/2005 Common Stock 2,000 $0.9844 59,600 D
Stock Options (Right to buy) $0.9844 05/07/1999 M 19,600 01/24/1997 01/24/2005 Common Stock 19,600 $0.9844 40,000 D
Stock Options (Right to buy) $1.4844 05/07/1999 M 400 01/25/1996 01/25/2004 Common Stock 400 $1.4844 0 D
Stock Options (Right to buy) $0.9844 09/02/1999 M 24,600 01/24/1997 01/24/2005 Common Stock 24,600 $0.9844 15,400 D
Explanation of Responses:
1. The number of options, the exercise price and the number of shares of common stock reflected herein have been adjusted to reflect a three-for-two stock split effected in February 1992 and three two-for-one stock splits effected in September 1997, January 1999 and April 2000.
Robert W Jewett 04/13/2005
** 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 4 (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.