3 1 edgar.htm 3 Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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Filed By
Romeo and Dye's
Section 16 Filer
www.section16.net

1. Name and Address of Reporting Person*

Principal Financial Group, Inc.

2. Date of Event
Requiring Statement
Month/Day/Year
4/11/2003

4. Issuer Name and Ticker or Trading Symbol
Patient Infosystems, Inc. (PAT1)

(Last)      (First)     (Middle)

711 High Street
 

3. I.R.S. Identification
Number of Reporting
Person, if an entity
(voluntary)

 

5. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
    Director                      X 10% Owner
    Officer                            Other
(give title below)              (specify below)

                                                  

6. If Amendment,
Date of Original
(Month/Day/Year)
 

(Street)

Des Moines, IA 50392

7. Individual or Joint/Group Filing
(Check Applicable Line)
    Form filed by One Reporting Person
X Form filed by More than One Reporting Person

(City)     (State)     (Zip)

Table I — Non-Derivative Securities Beneficially Owned

1. Title of Security
(Instr. 4)

2. Amount of
Securities
Beneficially
Owned
(Instr. 4)

3. Ownership Form:
Direct (D)
or Indirect (I)
(Instr. 5)

4. Nature of Indirect
Beneficial Ownership
(Instr. 5)
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5(b)(v).

Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number
FORM 3 (continued)

Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security
(Instr. 4)

2. Date Exercisable
and Expiration Date
(Month/Day/ Year)

3. Title and Amount of Securities
Underlying Derivative Security
(Instr. 4)

4. Conversion or
Exercise Price of
Derivative Security

5. Ownership Form
of Derivative
Security:
Direct (D)
or Indirect (I)
(Instr. 5)

6. Nature of Indirect Beneficial Ownership
(Instr. 5)

Date
Exercisable

Expiration
Date

Title          

Amount or
Number of
Shares

Series D Preferred Convertible Stock

Immediately

None

Common Stock

106,989(1)

$0.00

I

By Subsidiary

Explanation of Responses:

(1) The number of underlying shares of Common Stock is subject to adjustment for anti-dilution and other matters.
  By: /s/ Principal Financial Group, Inc.
             /s/ Joyce N. Hoffman, Senior Vice President and Corporate Secretary
**Signature of Reporting Person		 April 21, 2003
Date

**Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed.
          If space is insufficient, See Instruction 6 for procedure.

Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

 

 
                          JOINT FILER INFORMATION

                   Amount of Securities  Ownership Form    Nature of Indirect
Name and Address   Beneficially Owned   (D) or (I)         Beneficial Ownership

Principal Financial     106,989 shares of
Group, Inc.             Series D Preferred     I            By Principal Life Insurance
711 High Street         Convertible Stock                   Company
Des Moines, Iowa 50392

Principal Financial
Services, Inc.          106,989 shares of      I            By Principal Life Insurance
711 High street         Series D Preferred                  Company
Des Moines, Iowa 50392  Convertible Stock


Principal Life          106,989 shares of      D
Insurance Company       Series D Preferred
711 High Street         Convertible Stock
Des Moines, Iowa 50392























Signature Page for Joint Filers


PRINCIPAL FINANCIAL SERVICES, INC.


By: _/s/ Joyce N. Hoffman_____________________
    Joyce N. Hoffman
    Senior Vice President & Corporate Secretary


PRINCIPAL LIFE INSURANCE COMPANY


By: _/s/ Joyce N. Hoffman_____________________
    Joyce N. Hoffman
    Senior Vice President & Corporate Secretary