-----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, Evfhu/CiV3/3iGkP1oG3LLeIx9NoO+SbN1kwhrj6vEeJxSL9k45pFGRtQp9DIk+6 TqxRQQTmD0OFVmLQ/dJloA== 0000914190-97-000061.txt : 19970222 0000914190-97-000061.hdr.sgml : 19970222 ACCESSION NUMBER: 0000914190-97-000061 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970213 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEALTH FITNESS PHYSICAL THERAPY INC CENTRAL INDEX KEY: 0000886432 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 411580506 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-46567 FILM NUMBER: 97529964 BUSINESS ADDRESS: STREET 1: 3500 W 80TH ST STREET 2: STE 130 CITY: BLOOMINGTON STATE: MN ZIP: 55431 BUSINESS PHONE: 6128316830 MAIL ADDRESS: STREET 2: 3500 WEST 80TH STREET CITY: BLOOMINGTON STATE: MN ZIP: 55431 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KLINE GEORGE E CENTRAL INDEX KEY: 0000936972 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 4750 IDS CENTER CITY: MINNEAPOLIS STATE: MN ZIP: 55402 BUSINESS PHONE: 6123441900 MAIL ADDRESS: STREET 1: 4750 IDS CENTER CITY: MINNEAPOLIS STATE: MN ZIP: 55402 SC 13G/A 1 SCHEDULE 13G FOR GEORGE E. KLINE SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 1)* Health Fitness Physical Therapy, Inc. - ------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.01 par value - ------------------------------------------------------------------------------- (Title of Class of Securities) 42217V 10 2 -------------------------------------- (CUSIP Number) Check the following box if a fee is being paid with the statement [ ]. (A fee is not required only if the reporting 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 on 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). (Continued on following page(s)) Page 1 of 4 Pages SCHEDULE 13G CUSIP No. 42217V 10 2 Page 2 of 4 Pages - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON George E. Kline ###-##-#### - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A. - ------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES BENEFICIALLY 0 OWNED BY ---------------------------------------------------- EACH REPORTING 6 SHARED VOTING POWER PERSON WITH 267,032 (includes 130,000 shares which may be purchased upon exercise of exercisable warrants.) --------------------------------------------------- 7 SOLE DISPOSITIVE POWER 0 --------------------------------------------------- 8 SHARED DISPOSITIVE POWER 267,032 (includes 130,000 shares which may be purchased upon exercise of exercisable warrants.) - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 267,032 (includes 130,000 shares which may be purchased upon exercise of exercisable warrants.) - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES [ ] CERTAIN SHARES* - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 3.7% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! Item 1(a) Name of Issuer: Health Fitness Physical Therapy, Inc. Item 1(b) Address of Issuer's Principal Executive Offices: 3500 W. 80th Street Bloomington, MN 55431 Item 2(a) Name of Person Filing: See Cover Page Item 1 Item 2(b) Address of Principal Business Office or, if none, residence: 4750 IDS Center Minneapolis, MN 55402 Item 2(c) Citizenship: See Cover Page Item 4 Item 2(d) Title of Class of Securities: Common Stock, $.01 par value Item 2(e) CUSIP No.: See Cover Page Item 3 Statement Filed Pursuant to Rules 13d-1(b) or 13d-2(b): Not applicable Item 4(a) Amount Beneficially Owned: See Cover Page Item 9 Item 4(b) Percent of Class: See Cover Page Item 11 Item 4(c) Number of Shares as to Which Such Person Has: (i) sole power to vote or to direct the vote: See Cover Page Item 5 (ii) shared power to vote or to direct the vote: See Cover Page Item 6 (iii) sole power to dispose or to direct the disposition of: See Cover Page Item 7 (iv) shared power to dispose or to direct the disposition of: See Cover Page Item 8 Page 3 of 4 Item 5 Ownership of Five Percent or Less of a Class: Reporting person has ceased to be the beneficial owner of more than 5% of the Issuer's securities. 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: Not applicable 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 as of December 31, 1996. Dated: February 10, 1997 /s/ George E. Kline George E. Kline Page 4 of 4 -----END PRIVACY-ENHANCED MESSAGE-----