-----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, M2+3GsSYXjD7UwCfR2baOs8NEBSwglxtESDOeJ+hhX5bsZQjxjaTerNUj9soWkWM a9vg6VqZXzo0vOzUfXzLhw== 0001014739-03-000072.txt : 20031210 0001014739-03-000072.hdr.sgml : 20031210 20031210153914 ACCESSION NUMBER: 0001014739-03-000072 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031210 FILED AS OF DATE: 20031210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SICILIAN MICHAEL CENTRAL INDEX KEY: 0001175351 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28740 FILM NUMBER: 031047332 BUSINESS ADDRESS: STREET 1: C/O MIM CORP STREET 2: 100 CLEARBROOK ROAD CITY: ELMSFORD STATE: NY ZIP: 10523 BUSINESS PHONE: 9144601626 MAIL ADDRESS: STREET 1: C/O MIM CORP STREET 2: 100 CLEARBROOK ROAD CITY: ELMSFORD STATE: NY ZIP: 10523 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MIM CORP CENTRAL INDEX KEY: 0001014739 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 050489664 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 CLEARBROOK RD CITY: ELMSFORD STATE: NY ZIP: 10523 BUSINESS PHONE: 914 460 1600 MAIL ADDRESS: STREET 1: 33 NORTH ROAD CITY: PEACE DALE STATE: RI ZIP: 02883 4 1 sic42.xml X0201 4 2003-12-10 0 0001014739 MIM CORP MIMS 0001175351 SICILIAN MICHAEL 100 CLEARBROOK ROAD ELMSFORD NY 10523 0 1 0 0 EVP - Sales Common Stock, $.0001 par value 21400 D Employee Stock Option (Right to Buy) 7.9500 2003-12-10 4 A 0 35000 0 A 2004-09-24 2013-09-24 Common Stock, $.0001 par value 35000 35000 D Employee Stock Option (Right to Buy) 6.1400 2002-07-02 2011-07-02 Common Stock, $.0001 par value 100000 100000 D Employee Stock Option (Right to Buy) 10.6300 2003-06-04 2012-06-04 Common Stock, $.0001 par value 25000 25000 D Employee Stock Option (Right to Buy) 11.0500 2003-09-16 2013-09-16 Common Stock, $.0001 par value 15000 15000 D Includes 15,000 restricted shares of Common Stock issued to Mr. Sicilian on July 2, 2001. Such shares are subject to restrictions on transfer and encumbrance through prior to the scheduled vesting date and are automatically forfeited to the Company upon the termination of Mr. Sicilian's employment with the Company prior to prior to the scheduled vesting date. The restrictions to which the restricted shares are subject may lapse prior to prior to the scheduled vesting date upon the achievement by the Company of certain specified levels of earnings per share in future fiscal years prior to the scheduled vesting date. Vests and becomes exercisable in three equal annual installments commencing on September 24, 2004. Vests and becomes exercisable in three equal annual installments commencing on the first anniversary of the date of grant. /s/ Sicilian, Michael J. 2003-12-10 -----END PRIVACY-ENHANCED MESSAGE-----