-----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, BvAZS1v+F5B3cWt/ao10NBTTk15zUJcDfB+qT6V459qE/HzoQmNjHCGDtoGg5SmB i564P/FlHTZkwx9A3EV0ww== 0001014739-04-000046.txt : 20040616 0001014739-04-000046.hdr.sgml : 20040616 20040616113057 ACCESSION NUMBER: 0001014739-04-000046 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040615 FILED AS OF DATE: 20040616 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FORD HAROLD CENTRAL INDEX KEY: 0001176975 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28740 FILM NUMBER: 04865532 BUSINESS ADDRESS: STREET 1: 7966 FISHER ISLAND DRIVE CITY: MIAMI STATE: FL ZIP: 33109 BUSINESS PHONE: 3053729889 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 for55.xml X0202 4 2004-06-15 0 0001014739 MIM CORP MIMS 0001176975 FORD HAROLD 100 CLEARBROOK ROAD ELMSFORD NY 10523 1 0 0 0 Option to Purchase Common Stock 7.6800 2004-06-15 4 A 0 5000 0 A 2005-05-25 2014-05-25 Common Stock, $.0001 par value 5000 5000 D Option to Purchase Common Stock 3.5625 2009-02-10 Common Stock, $.0001 par value 25000 25000 D Option to Purchase Common Stock 5.9250 2002-06-28 2011-06-28 Common Stock, $.0001 par value 20000 20000 D Option to Purchase Common Stock 9.9400 2003-06-04 2012-06-04 Common Stock, $.0001 par value 5000 5000 D Option to Purchase Common Stock 6.5800 2004-06-05 2013-06-05 Common Stock, $.0001 par value 5000 5000 D Vests and becomes exercisable in three equal annual installments commencing on May 25, 2005. Fully Vested Vests and becomes exercisable in three equal annual installments commencing on the first anniversary of the date of grant. /s/ Ford, Harold 2004-06-15 -----END PRIVACY-ENHANCED MESSAGE-----