-----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, O/DVdNxvCDpXhZ847wSuevCCUqLL3QqmC3p40+Ig0MiQWODjdnM2CDZQt4sv6ejg o1DasnvUYnhDuGU15b+LyA== 0000898430-01-501859.txt : 20010815 0000898430-01-501859.hdr.sgml : 20010815 ACCESSION NUMBER: 0000898430-01-501859 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010418 FILED AS OF DATE: 20010814 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: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23125 FILM NUMBER: 1710464 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: LUSKIN MEYER/ CENTRAL INDEX KEY: 0001047072 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 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 5 1 d5.txt FORM 5 ================================================================================ Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires: October 31, 2001 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ UNITED STATES | FORM 5 | SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL 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 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Luskin Meyer ---------------------------------------------------------------------------- (Last) (First) (Middle) C/O OSI Systems, Inc. ---------------------------------------------------------------------------- (Street) 12525 Chadron Avenue Hawthorne, CA ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol OSI Systems, Inc. (OSIS) ----------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) -------------- 4. Statement for Month/Year 6/01 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) 7. Individual or Joint/Group Reporting (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 of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) Owned at the Direct Bene- Day/ end of (D) or ficial Year) Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
* If the form is filed by more than one reporting person, see instruction 4(b)(v). FORM 5 (continued) - -------------------------------------------------------------------------------- Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------- 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 of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------- (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- Options to purchase common stock $2.00 8/22/00 J 11,250 - ----------------------------------------------------------------------------------------------------------------------------- Option to purchase common stock $3.44 4/18/01 A 2,500 - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Title Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ * 8/22/00 Common 11,250 0 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ ** 4/18/06 Common 7,500 7,500 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: * Expired 11,250 options to purchase common stock on 8/22/00 ** Vested over four year period from the date of grant /s/ Meyer Luskin 8/10/01 -------------------------------- ----------------- **Signature of Reporting Person 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 provided is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----