-----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, SVGg2B2vXXoZOGn4f3RWBY/QLMN+1yBenFhdg3QkRKJMLjYA5hCCjLtrj3gWZTBh x/kKHrePoBBotWys6SEp+w== 0001026121-99-000007.txt : 19990205 0001026121-99-000007.hdr.sgml : 19990205 ACCESSION NUMBER: 0001026121-99-000007 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19990204 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LIFEPOINT INC CENTRAL INDEX KEY: 0000910523 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330539168 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-45889 FILM NUMBER: 99521061 BUSINESS ADDRESS: STREET 1: 10410 TRADEMARK ST CITY: RANCHO CUCAMONGA STATE: CA ZIP: 91730 BUSINESS PHONE: 9094668378 MAIL ADDRESS: STREET 1: 10410 TRADEMARK ST CITY: RANCHO CUCAMONGA STATE: CA ZIP: 91730 FORMER COMPANY: FORMER CONFORMED NAME: U S DRUG TESTING INC DATE OF NAME CHANGE: 19930811 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MELVIN SIMON & ASSOCIATES INC CENTRAL INDEX KEY: 0000937888 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 351093882 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: MERCHANTS PLAZA STREET 2: 115 WEST WASHINGTON ST SUITE 1600 CITY: INDIANAPOLIS STATE: IN ZIP: 46204 MAIL ADDRESS: STREET 1: MERCHANTS PLAZA STREET 2: 115 WEST WASHINGOTN ST CITY: INDIANAPOLIS STATE: IN ZIP: 46204 SC 13G 1 13-G FOR MELVIN SIMON & ASSOCIATES SCHEDULE 13G (Rule 13d-102) Information to be Included in Statements Filed Pursuant to Rule 13d-1(b), (c) and (d) and Amendments Thereto Filed Pursuant to Rule 13d-2. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. ___________________) LifePoint, Inc. (Name of Issuer) Common Stock, $.001 par value_ (Title of Class of Securities) 53215R 10 0 - -------------------------------------------------------------------------------- (CUSIP Number) January 21, 1999 (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: |_| Rule 13d-1(b) |X| Rule 13d-1(c) |_| Rule 13d-1(d) CUSIP No. 53215R 10 0 - --- ---------------------------------------------------------------------------- 1 Names of Reporting Persons/I.R.S. Identification Nos. of Above Persons (Entities Only) Melvin Simon & Associates, Inc. - 35-1093882 - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 2 Check the Appropriate Box if a Member of a Group (a) |_| (b) |_| - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 3 SEC Use Only - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 4 Citizenship or Place of Organization Indiana - --- ---------------------------------------------------------------------------- - --------------------------------- ------- -------------------------------------- Number of 5 Sole Voting Power Shares 525,000 before conversion and 1,000,000 after conversion Beneficially Owned by Each Reporting Person With - --------------------------------- ------- -------------------------------------- - --------------------------------- ------- -------------------------------------- 6 Shared Voting Power 0 - --------------------------------- ------- -------------------------------------- - --------------------------------- ------- -------------------------------------- 7 Sole Dispositive Power 1,000,000 - --------------------------------- ------- -------------------------------------- - --------------------------------- ------- -------------------------------------- 8 Shared Dispositive Power 0 - --------------------------------- ------- -------------------------------------- - --- ---------------------------------------------------------------------------- 9 Aggregate Amount Beneficially Owned by Each Reporting Person 1,000,000 - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 10 Check if the Aggregate Amount in Row (9) Excludes Certain Shares |_| - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 11 Percent of Class Represented by Amount in Row (9) 8.0% - --- ---------------------------------------------------------------------------- - --- ---------------------------------------------------------------------------- 12 Type of Reporting Person (See Instructions) CO - --- ---------------------------------------------------------------------------- Item 1(a) Name of Issuer: LifePoint, Inc. Item 1(b) Address of Issuer's Principal Executive Offices: 10400 Trademark Street, Rancho Cucamonga, CA 91370 Item 2(a) Name of Person Filing: Melvin Simon & Associates, Inc. Item 2(b) Address of Principal Business Office or, if None, Residence: 115 West Washington Street, Suite 1600, Indianapolis, IN 46204 Item 2(c) Citizenship: Indiana Item 2(d) Title of Class of Securities: Common Stock, $.001 par value Item 2(e) CUSIP Number: 53215R 10 0 Item 3 If this Statement is filed pursuant to Rule 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a: (a) |_| Broker or dealer registered under Section 15 of the Exchange Act. (b) |_| Bank as defined in Section 3(a)(6) of the Exchange Act. (c) |_| Insurance company registered under Section 8 of the Investment Company Act. (d) |_| Investment company registered under Section 8 of the Investment Company Act. (e) |_| An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E). (f) |_| An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F). (g) |_| A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G). (h) |_| A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act. (i) |_| A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act. (j) |_| Group, in accordance with Rule 13d-1(b)(1)(ii)(J). If this statement is filed pursuant to Rule 13d-1(c), check this box. |X| Item 4. Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 1,000,000 shares (25,000 shares are Series A Preferred Shares which can be converted at any time into 500,000 shares of the Common Stock.) (b) Percent of class: 8.0%. (c) Number of shares as to which the person has: (i) Sole power to vote or to direct the vote: 525,000 shares before the conversion and 1,000,000 shares after the conversion. (ii) Shared power to vote or to direct the vote: 0 shares. (iii) Sole power to dispose or to direct the disposition of: 525,000 shares before the conversion and 1,000,000 shares after the conversion. (iv) Shared power to dispose or to direct the disposition of: 0 shares. Item 5. Ownership of Five Percent or Less of a Class. If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ]. 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. Certifications. By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or 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 4, 1999 (Date) MELVIN SIMON & ASSOCIATES, INC. By: /s/Stephen Simon (Signature) Stephen Simon, President and Chief Operating Officer (Name and Title) -----END PRIVACY-ENHANCED MESSAGE-----