-----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, PCiyZ8HaBBf3Z5YYLNIbSWDu6cqpZWQ3iM59fvP9taQcyvTTqktht0fEcEJtfzpi 8125QHxETIaytqb0XP7TBQ== 0001014739-05-000014.txt : 20050125 0001014739-05-000014.hdr.sgml : 20050125 20050125160912 ACCESSION NUMBER: 0001014739-05-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050121 FILED AS OF DATE: 20050125 DATE AS OF CHANGE: 20050125 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: 05547313 BUSINESS ADDRESS: 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 sic67.xml X0202 4 2005-01-21 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 2005-01-21 4 M 0 6783 6.1400 A 28183 D Common Stock, $.0001 par value 2005-01-21 4 S 0 6783 6.2006 D 21400 D Employee Stock Option (Right to Buy) 6.1400 2005-01-21 4 M 0 6783 0 D 2002-07-02 2011-07-02 Common Stock, $.0001 par value 6783 0 D Vests and becomes exercisable in three equal annual installments commencing on the first anniversary of the date of grant. /s/ Sicilian, Michael J. 2005-01-24 -----END PRIVACY-ENHANCED MESSAGE-----