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) 11/02/2011 |
3. Issuer Name and Ticker or Trading Symbol
CAREFUSION Corp [ CFN ] |
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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 | 17,716 | 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 | ||||
Options (right to buy)(1) | (2) | 08/15/2014 | Common Stock | 365 | $17.77 | D | |
Options (right to buy)(1) | (3) | 08/15/2015 | Common Stock | 11,076 | $31.9 | D | |
Options (right to buy) | (4) | 09/15/2016 | Common Stock | 39,516 | $20.71 | D | |
Restricted Stock Units(5) | (6) | (6) | Common Stock | 7,080 | $0(7) | D | |
Restricted Stock Units(5) | (8) | (8) | Common Stock | 4,248 | $0(7) | D | |
Options (right to buy) | (9) | 08/16/2017 | Common Stock | 31,377 | $22.59 | D | |
Restricted Stock Units(5) | (10) | (10) | Common Stock | 6,491 | $0(7) | D | |
Restricted Stock Units(5) | (11) | (11) | Common Stock | 19,478 | $0(7) | D | |
Options (right to buy) | (12) | 08/15/2018 | Common Stock | 30,700 | $25.56 | D | |
Restricted Stock Units(5) | (13) | (13) | Common Stock | 4,475 | $0(7) | D |
Explanation of Responses: |
1. Stock options originally granted by Cardinal Health, Inc. ("Cardinal Health"). Pursuant to the anti-dilution provisions of each stock option, the exercise price and number and kind of shares subject to each stock option were adjusted in conjunction with the spinoff of CareFusion Corporation from Cardinal Health on August 31, 2009. |
2. Stock options granted in connection with the voluntary stock option exchange program conducted by Cardinal Health, with respect to stock options previously awarded by Cardinal Health. Pursuant to the stock option exchange program and the original terms of these stock options, these stock options are now fully exercisable. |
3. Stock options granted subject to multi-year vesting based on original grant date. These stock options are now fully exercisable. |
4. Stock options granted on September 15, 2009. These stock options are exercisable with respect to 26,344 shares and will vest as to 13,172 shares on September 15, 2012. |
5. Each restricted stock unit represents a contingent right to receive one share of CareFusion common stock upon vesting. |
6. Restricted stock units granted on September 15, 2009. The shares reflected above represent the unvested portion of the award, which will vest as to 7,080 shares on September 15, 2012. |
7. Granted without payment by grantee. |
8. Restricted stock units granted on September 15, 2009. The shares reflected above represent the unvested portion of the award, which will vest as to 4,248 shares on September 15, 2012. |
9. Stock options granted on August 16, 2010. These stock options are exercisable with respect to 10,459 shares and will vest as to 10,459 shares on each of August 16, 2012 and August 16, 2013. |
10. Restricted stock units granted on August 16, 2010. The shares reflected above represent the unvested portion of the award, which will vest as to 3,245 shares on August 16, 2012 and 3,246 shares on August 16, 2013. |
11. Restricted stock units granted on August 16, 2010. This award will vest in full on August 16, 2013. |
12. Stock options granted on August 15, 2011. These stock options will vest as to 10,233 shares on August 15, 2012, 10,233 shares on August 15, 2013, and 10,234 shares on August 15, 2014. |
13. Restricted stock units granted on August 15, 2011. These restricted stock units will vest as to 1,491 shares on August 15, 2012, 1,492 shares on August 15, 2013, and 1,492 shares on August 15, 2014. |
Remarks: |
Nathaniel Sisitsky, Attorney-in-Fact | 11/10/2011 | |
** 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. |