-----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, PZodrwKk9IxF8S2NOBVLD9OEKy7+S4bia/lKbIqy5HQOxcogeStK42EjLYQnfr+X sf7j3KeLe5lDGXHk/P5Jfg== 0000898430-01-501354.txt : 20010718 0000898430-01-501354.hdr.sgml : 20010718 ACCESSION NUMBER: 0000898430-01-501354 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010601 FILED AS OF DATE: 20010717 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OSI SYSTEMS INC CENTRAL INDEX KEY: 0001039065 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 330238801 STATE OF INCORPORATION: CA FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-23125 FILM NUMBER: 1682625 BUSINESS ADDRESS: STREET 1: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 90250 BUSINESS PHONE: 3109780516 MAIL ADDRESS: STREET 1: 12525 CHADRON AVENUE CITY: HAWTHORNE STATE: CA ZIP: 90250 COMPANY DATA: COMPANY CONFORMED NAME: HICKMAN THOMAS K CENTRAL INDEX KEY: 0001047064 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O OSI SYSTEMS INC STREET 2: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 70250 MAIL ADDRESS: STREET 2: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 90250 4 1 d4.txt FORM 4 /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number 3235-0287 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Hickman Thomas - -------------------------------------------------------------------------------- (Last) (First) (Middle) 12525 Chadron Avenue - -------------------------------------------------------------------------------- (Street) Hawthorne California 90250 - -------------------------------------------------------------------------------- (City) (State) (Zip) * If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol OSI SYSTEMS, INC. (OSIS) ----------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) -------------- 4. Statement for Month/Year 7/01 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) X Director ___ Officer ___ 10% Owner ___ Other --- (give title below) (specify below) ---------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person ---- ____ Form filed by More than One Reporting Person Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 6/01/01 M $37,500 A $2.50 15,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ (Over)
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed (D) of Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security ---------------------------------------------------- Code V (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- Emplpyee Stock Option $2.50 6/1/01 M 15,000 - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Nature cisable and Underlying Securities of of Deriv- ship Form of In- Expiration (Instr. 3 and 4) Deriv- ative of De- direct Date ative Secur- rivative Bene- (Month/Day/ Secur- ities Secu- ficial Year) ity Bene- rity: Owner- (Instr. 5) ficially Direct ship -------------------------------------------- Owned (D) or (Instr. 4) Date Expira- Amount or at End Indirect Exer- tion Title Number of of month (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ (1) 6/4/01 Common Stock 15,000 $2.50 - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Entire employee stock option is vested. ** Intentional misstatements or omissions of facts constitute Federal /s/ Thomas Hickman 7/13/01 Criminal Violations. --------------------------------- ---------- See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----