-----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, R81lLmNrINbMOkWXDbB2v2vN1VTSRt+nvY6ommZuPIibNIRSpCu1DyacabjgwAqd MhYrns25colPfSKcvmqYkg== 0000950109-96-000765.txt : 19960216 0000950109-96-000765.hdr.sgml : 19960216 ACCESSION NUMBER: 0000950109-96-000765 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960213 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LIFELINE SYSTEMS INC CENTRAL INDEX KEY: 0000720195 STANDARD INDUSTRIAL CLASSIFICATION: RADIO & TV BROADCASTING & COMMUNICATIONS EQUIPMENT [3663] IRS NUMBER: 042537528 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-35787 FILM NUMBER: 96517651 BUSINESS ADDRESS: STREET 1: 640 MEMORIAL DRIVE CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 6176791000 MAIL ADDRESS: STREET 2: 640 MEMORIAL DRIVE CITY: CAMBRIDGE STATE: MA ZIP: 02139-4851 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SHAPIRO L DENNIS CENTRAL INDEX KEY: 0000903404 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 24 ESSEX ROAD CITY: CHESTNUT HILL STATE: MA ZIP: 02167 BUSINESS PHONE: 617-277-6886 MAIL ADDRESS: STREET 1: 24 ESSEX ROAD CITY: CHESTNUT HILL STATE: MA ZIP: 02167 SC 13G 1 SCHEDULE 13-G ------------------------ OMB APPROVAL UNITED STATES ------------------------ SECURITIES AND EXCHANGE COMMISSION OMB Number. 3235-0145 WASHINGTON. D.C. 20549 Expires: August 31, 1991 Estimated average burden hours per response..1490 ------------------------ SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 LIFELINE SYSTEMS, INC. - -------------------------------------------------------------------------------- (Name of Issuer) COMMON STOCK $.02 Par Value - -------------------------------------------------------------------------------- (Title of Class of Securities) 532192 10 1 ------------------------- (CUSIP Number) Check the following box if a fee is being paid with this statement [X]. (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). - ----------------------- --------------------- CUSIP NO. 532192 10 1 13G PAGE 2 OF 2 PAGES ------------ --- --- - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON L. Dennis Shapiro - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [_] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 456,600 (beneficial interest disclaimed in 2,750) SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 96,490 (beneficial interest disclaimed in 96,490) OWNED BY ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING 456,600 (beneficial interest disclaimed in 2,750) PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 96,490 (beneficial interest disclaimed in 96,490) - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 453,850 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 X - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 13.0 - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 IN - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Item 1(a) Name of Issuer: ------------------------- Lifeline Systems, Inc. Item 1(b) Address of Issuer's Principal Executive Offices: ---------------------------------------------------------- One Arsenal Marketplace Watertown, MA 02172 Item 2(a) Name of Person Filing: -------------------------------- L. Dennis Shapiro Item 2(b) Address of Principal Business Office: ----------------------------------------------- 24 Essex Road Chestnut Hill, MA 02167 Item 2(c) Citizenship: ---------------------- United States Item 2(d) Title of Class of Securities: --------------------------------------- Common Stock, Par Value $.02 Item 2(e) Cusip Number: ----------------------- 532192 10 1 Item 3: This Item is inapplicable. ------ Item 4 Ownership: -------------------- a. Amount Beneficially Owned: 553,090, except as this amount may be limited by the explanations contained in paragraphs 2 through 6 below: 1. 453,850 shares are owned directly by Mr. Shapiro, which includes 52,200 shares that Mr. Shapiro has the right to acquire. 2. 2,750 shares are in the name of Mr. Shapiro as custodian for his children. Mr. Shapiro has voting and dispositive power over such shares, but he disclaims any beneficial interest. 3. 11,375 shares are in the name of Mr. Shapiro's children. Mr. Shapiro has shared voting and shared dispositive power over such shares, but he disclaims any beneficial interest. 4. 8,240 shares are in the name of Mr. Shapiro's wife, as custodian for their children. Mr. Shapiro has shared voting and shared dispositive power over such shares, but he disclaims any beneficial interest. 5. 50,000 shares are in the name of Mr. Shapiro's wife as a co-trustee of three trusts. Mr. Shapiro has shared voting and shared dispositive power over such shares, but he disclaims any beneficial interest. 6. 26,875 shares are in the name of Mr. Shapiro's wife. Mr. Shapiro has shared voting and shared dispositive power over such shares, but he disclaims any beneficial interest. b. Percent of class: 13.0%. c. Number of shares as to which such person has: (i) sole power to vote or direct the vote: 456,600 shares (which includes 52,200 shares which Mr. Shapiro has the right to acquire); (ii) shared power to vote or direct the vote: 96,490 shares; (iii) sole power to dispose of or to direct the disposition of 456,600 shares (which includes 52,200 which Mr. Shapiro has the right to acquire); and (iv) shared power to dispose of or to direct the disposition of 96,490 shares. Item 5 Ownership of Five Percent or Less of a Class: -------------------------------------------------------- This Item is inapplicable. Item 6 Ownership of More than Five Percent on Behalf of Another ------------------------------------------------------------------- Person: ------ Mr. Shapiro holds 2,750 shares as custodian for his children. Mr. Shapiro's wife holds 8,240 for their children. These children have the right to receive any dividends which may be declared and any proceeds from the sale of these securities. Mr. Shapiro's wife holds 50,000 shares as a co-trustee of three trusts. The trusts, in which Mr. Shapiro holds no interest, have the right to receive any dividends which may be declared and any proceeds from the sale of these securities. Mr. Shapiro's children own 11,375 shares and have the right to receive any dividends which may be declared and any proceeds from the sale of these securities. Mr. Shapiro's wife owns 26,875 shares and has the right to receive any dividends which may be declared and any proceeds from the sale of these securities. Item 7 Identification and Classification of the Subsidiary Which -------------------------------------------------------------------- Required the Security Being Reported on by the Parent Holding ------------------------------------------------------------- Company: ------- This Item is inapplicable. Item 8 Identification and Classification of Members of the Group: -------------------------------------------------------------------- This Item is inapplicable. Item 9 Notice of Dissolution of Group: ----------------------------------------- This Item is inapplicable. Item 10 Certification: ------------------------ This Item is inapplicable. 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. /s/ L. Dennis Shapiro ---------------------- L. Dennis Shapiro Dated: February 13, 1991 -----END PRIVACY-ENHANCED MESSAGE-----