-----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, Cy6UdYJpOkooUa5MQH1HoII2swEo/lWia/mhTdV++xGyqJQ71Nq8jDc6D/JJ87/J QAt3AWd0WjBh81LytZ2llw== 0000827056-00-000001.txt : 20000210 0000827056-00-000001.hdr.sgml : 20000210 ACCESSION NUMBER: 0000827056-00-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991231 FILED AS OF DATE: 20000209 SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-12965 FILM NUMBER: 528510 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 COMPANY DATA: COMPANY CONFORMED NAME: MCSTOTTS PHILIP L CENTRAL INDEX KEY: 0001040116 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: ZEVEX STREET 2: 4314 ZEVEX PARK LANE CITY: SALT LAKE CITY STATE: UT ZIP: 84123 BUSINESS PHONE: 8012641001 MAIL ADDRESS: STREET 1: ZEVEX STREET 2: 4314 ZEVEX PARK LANE CITY: SALT LAKE CITY STATE: UT ZIP: 84123 4 1 FORM 4 PHILLIP L.MCSTOTTS U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENFICIAL OWNERSHIP 1. Name and Address of Reporting Person: Phillip L. McStotts, 746 Quaking Aspen, Murray, UT 84123 2. Issuer Name and Ticker or Trading Symbol: ZEVEX International, ZVXI. 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement for Month/Year: 12/99 5. If Amendment, Date of Original (Month/Year): 6. Relationship of Reporting Person to Issuer (Check all applicable): (X) Director (X) Officer (give title below) ( ) 10% Owner ( ) Other (specify below) Title: Chief Financial Officer TABLE I -- Non-Derivative Securities Beneficially Owned
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount 6. Owner- 7. Nature action action or Disposed of (D) of ship of In- Date Code Securities Form direct (M/D/Y) Beneficially Direct Benefic- Owned at (D) or ial End of Indirect Owner- Amount (A) or (D) Price Month (I) ship - --------------------- ------------ ------------ -------------------------- ------------ --------- ------------
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of 2. Conver- 3.Trans- 4. Trans- 5. Number of 6. Date 7. Title and 8. Price 9. Num- 10. Own- 11. Na- Deriv- sion or action action Derivative Exer- and Am- of ber of ership ture ative Exercise Date Code Securities cisable ount of Deriv- Deriv- Form of In- Security Price of (M/D/Y) Acquired and Ex- Under- ative ative of De- direct Deriv- (A) or Dis- piration lying Secur- Secur- rivative Benef- ative posed of (D) Date Securities ity ities Security: icial Security (M/D/Y) Bene- Direct (D) Own ---------- ------------ ficially or Indirect ership Date Epir- Title Amount Owned (I) Exer-ation or Number at End of cisable Date of shares Month - ----------- ----------- --------- -------- -------------- ------------ ------------- ------ ---------- ---------- --------- Employee Stock Option (Right to Buy) 5.0000 1/08/99 A* 10,000 1/01/00 10/07/08 Common Stock 10,000 0 Employee Stock Option (Right to Buy) 5.0000 1/01/00 A* 10,000 1/01/01 10/07/08 Common Stock 10,000 0 Employee Stock Option (Right to Buy) 5.0000 1/01/01 A* 10,000 1/01/02 10/07/08 Common Stock 10,000 0 30,000 D
*All of the Option Shares shall become purchasable by the Optionee the date which is nine years and nine months following the Grant Date if the Optionee is continuously in the Service of the Corporation during that time. Additionally, one-third of the Option Shares (10,000 shares or a portion thereof, as described below) shall become purchasable following each of the first three anniversary dates of the Grant Date upon the Corporation's achieving certain annual revenue and earnings in the three fiscal years ending December 31, 1999, 2000, and 2001.
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