-----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, QXV7/ktn0hdCAWtorm7iPsfPgpTOOdpLfek1qKM5WhI8QNGN7AU5mQUBVvqvBEEf u4Fk8jmX910IHGEiQ4oY+g== 0000827056-05-000037.txt : 20051215 0000827056-05-000037.hdr.sgml : 20051215 20051215182837 ACCESSION NUMBER: 0000827056-05-000037 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051214 FILED AS OF DATE: 20051215 DATE AS OF CHANGE: 20051215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KAYSEN DAVID B CENTRAL INDEX KEY: 0001133026 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12965 FILM NUMBER: 051267829 BUSINESS ADDRESS: BUSINESS PHONE: 6516380419 MAIL ADDRESS: STREET 1: 1811 OLD HIGHWAY 8 CITY: NEW BRIGHTON STATE: MN ZIP: 55112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ZEVEX INTERNATIONAL INC CENTRAL INDEX KEY: 0000827056 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 870462807 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4314 ZEVEX PARK LANE CITY: MURRAY STATE: UT ZIP: 84123 BUSINESS PHONE: 8012641001 MAIL ADDRESS: STREET 1: 4314 ZEVEX PARK LANE CITY: MURRAY STATE: UT ZIP: 84123 FORMER COMPANY: FORMER CONFORMED NAME: DOWNEY INDUSTRIES INC DATE OF NAME CHANGE: 19880811 4 1 f4dkaysen121505_ex.xml X0202 4 2005-12-14 0 0000827056 ZEVEX INTERNATIONAL INC ZVXI 0001133026 KAYSEN DAVID B 1811 OLD HIGHWAY 8 NEW BRIGHTON MN 55112 1 0 0 0 Common 12.83 2005-12-14 2005-12-14 4 A 0 10000 12.83 A 2005-12-14 2012-12-14 Common Stock 10000 45000 D Issued pursuant to Section 16b-3 Dave Kaysen 2005-12-15 -----END PRIVACY-ENHANCED MESSAGE-----