-----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, SPBzekB23l883grg3KyjSgFfUiC9cT9JW3BRgItA5L0YGR+dhtnHxYw0HdOQaXjJ Edte1U22voFrGduS+InJyg== 0001179110-03-011693.txt : 20031203 0001179110-03-011693.hdr.sgml : 20031203 20031203083724 ACCESSION NUMBER: 0001179110-03-011693 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031103 FILED AS OF DATE: 20031203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBSON HARRY R CENTRAL INDEX KEY: 0001255835 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28701 FILM NUMBER: 031033864 MAIL ADDRESS: STREET 1: 836 GLEN LEVEN DRIVE CITY: NASHVILLE STATE: TN ZIP: 37204 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHGATE DATA CORP CENTRAL INDEX KEY: 0001081630 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 043220927 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 25 CORPORATE DRIVE STREET 2: STE 310 CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 7816854000 MAIL ADDRESS: STREET 1: 25 CORPORATE DRIVE STREET 2: STE 310 CITY: BURLINGTON STATE: MA ZIP: 01803 4 1 edgar.xml FORM 4 - X0201 4 2003-11-03 0 0001081630 HEALTHGATE DATA CORP HGAT 0001255835 JACOBSON HARRY R 25 CORPORATE DRIVE, SUITE 310 BURLINGTON MA 01803 1 0 0 0 Common Stock 2003-11-03 4 P 0 1100 .50 A 1100 I As custodian for child and/or grandchild Common Stock 2003-11-06 4 P 0 200 .50 A 1300 I As custodian for child and/or grandchild Common Stock 2003-11-11 4 P 0 183 .50 A 1483 I As custodian for child and/or grandchild Common Stock 2003-12-01 4 P 0 1800 .50 A 3283 I As custodian for child and/or grandchild Common Stock 2003-12-01 4 P 0 717 .45 A 4000 I As custodian for child and/or grandchild Common Stock 115700 I by EBM Solutions, Inc. Common Stock 55556 D Stock Options .70 2003-10-27 2008-10-27 Common Stock 35000 35000 D Common Stock Warrant 1.2 2003-10-27 2005-04-27 Common Stock 51282 51282 I by EBM Solutions, Inc. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Does not include the 4,000 shares held indirectly by the reporting person as custodian for his children and grandchildren. Represents shares of the issuer held by EBM Solutions, Inc. ("EBM") and such shares are expected to be distributed to the reporting person upon EBM's anticipated liquidation. The reporting person is a director and shareholder of EBM. The reporting person disclaims beneficial ownership of the other 636,348 shares of the issuer which are held by EBM and which will be distributed to its other shareholders upon its liquidation; this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. Represents shares of common stock issuable under a warrant of the issuer held by EBM and such warrants are expected to be distributed to the reporting person upon EBM's anticipated liquidation. The reporting person is a director and shareholder of EBM. The reporting person disclaims beneficial ownership of the other 282,051 shares of common stock issuable under a warrant of the issuer which is held by EBM and which will be distributed to its other shareholders upon its liquidation; this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. Subject to vesting. /s/ Harry R. Jacobson 2003-12-02 -----END PRIVACY-ENHANCED MESSAGE-----