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) 11/14/2007 |
3. Issuer Name and Ticker or Trading Symbol
Virtual Radiologic CORP [ VRAD ] |
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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, par value $0.001 per share | 25,000 | D |
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 | ||||
Stock Options (right to buy) | 01/02/2004 | 01/02/2014 | Common Stock, par value $0.001 per share | 147,727 | $1 | D | |
Stock Options (right to buy) | (1) | 04/12/2017 | Common Stock, par value $0.001 per share | 48,000(1) | $12 | D | |
Stock Options (right to buy) | (2) | (2) | Common Stock, par value $0.001 per share | 5,000(2) | (2) | D |
Explanation of Responses: |
1. Vests as to 12,000 shares on March 31 of each year for four years beginning on March 31, 2008. |
2. Reflects stock options to be granted on the date that Virtual Radiologic Corporation's Registration Statement on Form S-1 is declared effective, with an exercise price equal to the public offering price of one share of common stock. The stock options will be exercisable for a period of 10 years and will vest as to 1,250 shares on each anniversary of the date of grant for four years. |
Remarks: |
Exhibit 24.1 - Power of Attorney |
/s/ George H. Frisch, Attorney-in-Fact | 11/14/2007 | |
** 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. |