-----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, VTAzYzkV2Ukf+hGMVIJ6Igt8Prz3kfHq9BrBfIHHd4kxYh0qsmvdIcIN1OjqkvwC xJvkyJbZYjlK6vaMOjKYLA== 0000897101-97-000136.txt : 19970222 0000897101-97-000136.hdr.sgml : 19970222 ACCESSION NUMBER: 0000897101-97-000136 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970213 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OXBORO MEDICAL INTERNATIONAL INC CENTRAL INDEX KEY: 0000350557 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411391803 STATE OF INCORPORATION: MN FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-39697 FILM NUMBER: 97531426 BUSINESS ADDRESS: STREET 1: 13828 LINCOLN ST N E CITY: HAM LAKE STATE: MN ZIP: 55304 BUSINESS PHONE: 6127559516 MAIL ADDRESS: STREET 1: 13828 LINCOLN STREET NE STREET 2: 13828 LINCOLN STREET NE CITY: HAM LAKE STATE: MN ZIP: 55304 FORMER COMPANY: FORMER CONFORMED NAME: LIFE CENTERS INC DATE OF NAME CHANGE: 19900516 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: RASMUSSON LARRY CENTRAL INDEX KEY: 0000938703 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 13828 LINCOLN ST NE CITY: HAM LAKE STATE: MN ZIP: 55304 SC 13G/A 1 ---------------------------- UNITED STATES OMB APPROVAL SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ---------------------------- OMB Number: 3235-0145 Expires: October 31, 1994 Estimated average burden hours per response....14.90 ---------------------------- SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 3)* Oxboro Medical International, Inc. (Name of Issuer) Common Stock, Par Value $0.01 Per Share (Title of Class of Securities) 691384 10 1 (CUSIP Number) Check the following box if a fee is being paid with this statement |_|. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7). *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). SEC 1745 (2-95) Page 1 of 4 pages CUSIP No. 691384 10 1 13G Page 2 of 4 Pages - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Larry Rasmusson Social Security # ***-**-**** - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| N/A (b) |_| - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America - ------------------------------------------------------------------------------- 5 SOLE VOTING POWER 532,770 NUMBER OF SHARES ------------------------------------------------ BENEFICIALLY 6 SHARED VOTING POWER OWNED BY EACH 6,693 (held in ESOP) REPORTING ------------------------------------------------ PERSON 7 SOLE DISPOSITIVE POWER WITH 532,770 ------------------------------------------------ 8 SHARED DISPOSITIVE POWER 6,693 (held in ESOP) - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 539,463 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* N/A - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 20.19% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* Individual (IN) - -------------------------------------------------------------------------------- * SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 4 pages AMENDMENT NO. 3 TO SCHEDULE 13-G ITEM 1. NAME AND ADDRESS OF ISSUER: Oxboro Medical International, Inc. 13828 Lincoln Street N.E. Ham Lake, Minnesota 55304 ITEM 2. NAME AND ADDRESS OF PERSON FILING: a. Larry Rasmusson b. 13828 Lincoln Street N.E. Ham Lake, Minnesota 55304 c. United States of America d. Common Stock, Par Value $0.01 Per Share e. 691384 10 1 ITEM 3. RULE 13-3(b), or 13d-2(b): Not Applicable ITEM 4. OWNERSHIP: a. Amount Beneficially Owned: 539,463 b. Percent of Class: 20.19% c. Number of Shares as to which such person has: (i) sole power to vote or direct the vote 532,770 (ii) shared power to vote or to direct the vote 6,693* (iii) sole power to dispose or to direct the disposition of 532,770 (iv) shared power to dispose or to direct the disposition of 6,693* * held in ESOP Page 3 of 4 pages ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS: Not Applicable ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON: Not Applicable ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY: Not Applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP: Not Applicable ITEM 9. NOTICE OF DISSOLUTION OF GROUP: Not Applicable ITEM 10. CERTIFICATION: By signing below, I certify that to the best of my knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or as a participant in any transaction having such purpose of effect. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 12, 1997 ------------------------------------- Date /s/ Larry Rasmusson ------------------------------------- Signature Larry Rasmusson Page 4 of 4 pages -----END PRIVACY-ENHANCED MESSAGE-----