-----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, STzdBK4vV4/cMBnShYgkaREa4cEsRftP7I5XxnAuDVQWK/7E4hTPGlbOGZAYbvQj Sx7Tj1qQ3M+fQ50SxKDf4g== 0000351721-03-000169.txt : 20030502 0000351721-03-000169.hdr.sgml : 20030502 20030502161530 ACCESSION NUMBER: 0000351721-03-000169 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030502 FILED AS OF DATE: 20030502 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: HAWARI KENNETH G CENTRAL INDEX KEY: 0001192861 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: 6501 WINDCREST DR STREET 2: SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ADVANCED NEUROMODULATION SYSTEMS INC CENTRAL INDEX KEY: 0000351721 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 751646002 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-10521 FILM NUMBER: 03679976 BUSINESS ADDRESS: STREET 1: 6501 WINDCREST DRIVE SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 BUSINESS PHONE: 9723098000 MAIL ADDRESS: STREET 1: 6501 WINDCREST DRIVE SUITE 100 CITY: PLANO STATE: TX ZIP: 75024 FORMER COMPANY: FORMER CONFORMED NAME: QUEST MEDICAL INC DATE OF NAME CHANGE: 19920703 4 1 hawari050203.txt FORM 4 ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response.........0.5 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 |_| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print of Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Hawari Kenneth G. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 3605 Edgestone - -------------------------------------------------------------------------------- (Street) Plano Texas 75093 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Advanced Neuromodulation Systems, Inc. (ANSI) ________________________________________________________________________________ 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) ________________________________________________________________________________ 4. Statement for Month/Day/Year 05/02/03 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) |_| Director |_| 10% Owner |X| Officer (give title below) |_| Other (specify below) General Counsel and Exeutive Vice President-Corporate Development ________________________________________________________________________________ 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 ================================================================================
5. Amount of 6. 4. Securities Owner- Securities Acquired (A) or Beneficially ship 2A. 3. Disposed of (D) Owned Form: 7. 2. Deemed Transaction (Instr. 3, 4 and 5) Following Direct Nature of Trans- Execution Code ------------------------------- Reported (D) or Indirect 1. action Date, if (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Date any ------------ or (Instr. 3 & (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V Amount (D) Price Instr.4) (Instr.4) (Instr.4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/01/03 M 5,000 A $28.53 5,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/01/03 S 5,000 D $42.0130 0 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 M 5,000 A $28.53 5,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 S 5,000 D $42.3238 0 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 M 5,000 A $28.53 5,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 S 5,000 D $42.4030 0 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 M 5,000 A $28.53 5,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/02/03 S 5,000 D $43.3080 0 D ====================================================================================================================================
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. Number 10. of Owner- deriv- ship ative Form 2. Secur- of Conver- 5. 7. ities Deriv- 11. sion Number of Title and Amount Bene- ative Nature or Derivative 6. of Underlying 8. ficially Secur- of Exer- 3A. 4. Securities Date Securities Price Owned ity: In- cise Deemed Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Follow- Direct direct Price 3. Execut- action or Disposed Expiration Date ---------------- Deriv- ing (D) or Bene- 1. of Trans- ion Code of(D) (Month/Day/Year) Amount ative Reported In- ficial Title of Deriv- action Date if (Instr. (Instr. 3, ---------------- or Secur- Trans- direct Owner- Derivative ative Date any 8) 4 and 5) Date Expira- Number ity action(s) (I) ship Security Secur- (mm/dd/ (mm/dd/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity yy) yy) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option $28.53 05/01/03 M 5,000 Immed. 02/21/12 Common 5,000 70,000 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option $28.53 05/02/03 M 15,000 Immed. 02/21/12 Common 15,000 55,000 D Stock - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: Kenneth G. Hawari By:/s/Linda D. Moses, Agent and Attorney-in-Fact for Kenneth G. Hawari May 2, 2003 - ------------------------------------------------------ ----------------------- **Signature of Reporting Person Date 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 4(b)(v). ** 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. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----