X0303 4 2009-12-22 1 0000823560 MTS MEDICATION TECHNOLOGIES, INC /DE/ MTSI 0001031593 SIEGEL TODD E 2003 GANDY BLVD. NORTH SUITE 800 ST. PETERSBURG FL 33702 1 1 1 0 Pres., CEO, COB Common Stock 2009-12-22 4 S 0 1000000 D 606125 I By: Jade Partners Common Stock 2009-12-22 4 D 0 606125 D 0 I By: Jade Partners Common Stock 2009-12-22 4 D 0 61908 D 0 D Common Stock 2009-12-22 4 D 0 1100 D 0 I By: Son Options (right to buy) 5.85 2009-12-22 4 D 0 56777 D 2018-07-02 Common Stock 56777 0 D Disposed of pursuant to an Agreement and Plan of Merger, dated as of August 7, 2009 ("Merger Agreement"), by and among the Issuer, MedPak Holdings, Inc., a Delaware corporation ("Parent"), and MedPak Merger Sub, Inc., a Delaware corporation and a wholly owned subsidiary of Parent ("Merger Sub"), whereby Merger Sub merged with and into the Issuer (the "Merger"). 1,000,000 shares of the Issuer's common stock held by the reporting person were exchanged for 206,834 shares of Preferred Stock and 206,834 shares of Voting Common Stock of the Parent. The reporting person's remaining shares were exchanged for cash consideration of $5.75 per share (the "Merger Consideration"). The Merger was approved by the stockholders of the Issuer on December 18, 2009 and became effective on December 22, 2009. Options vested as follows: 18,925 on 07/02/2009; 18,926 on 07/02/2010; and 18,926 on 07/02/2011. The options were cancelled and terminated by the Issuer's Board of Directors in accordance with the terms of the Merger Agreement. The reporting person received, with respect to any shares of the Issuer's common stock issuable under a stock option, an amount equal to the excess, if any, of (i) the Merger Consideration per share over (ii) the exercise price per share payable with respect of such shares of the Issuer's common stock issuable under such stock option. Todd Siegel 2009-12-22