SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Mann Thomas Kelly

(Last) (First) (Middle)
MEDIWARE INFORMATION SYSTEMS, INC.
11711 WEST 79TH STREET

(Street)
LENEXA KS 66214

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MEDIWARE INFORMATION SYSTEMS INC [ MEDW ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
CEO and President
3. Date of Earliest Transaction (Month/Day/Year)
11/09/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/09/2012 D 284,309 D $22(1) 50,000 D
Common Stock 11/09/2012 D 50,000 D $25.78(2) 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $9.11 11/09/2012 D 100,000 07/01/2011(3) 07/01/2015 Common Stock 100,000 $12.89(3) 0 D
Explanation of Responses:
1. Disposed of pursuant to merger of issuer and Project Ruby Merger Corp. in exchange for a cash payment of $22.00 per share.
2. Of these shares of restricted stock, 12,500 shares were to vest on 6/30/2013 if the price of the issuer's common stock had increased ten percent (10%) from the prior fiscal year and 37,500 shares were to vest upon the filing of the issuer's 2013 Form 10-K if the issuer's Board of Directors determined that the performance metrics setting out the vesting requirements for each respective tranche were achieved. These shares of restricted stock were terminated on the effective date of the merger in exchange for a cash payment equal to two times the difference between $22.00 and $9.11 for each share.
3. These options were to vest annually ratably beginning 7/01/2011. Each option was canceled pursuant to the merger agreement between issuer and Project Ruby Parent Corp. and Project Ruby Merger Corp. in exchange for a cash payment representing the amount by which $22.00 exceeds the exercise price of the option multiplied by the number of shares for which the option is exercisable.
/s/ T. KELLY MANN 11/09/2012
** 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).
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