3 1 form3jackson12-02.htm Form 3


Form 3

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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(f) of the Investment Company Act of 1940

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(Print or Type Responses)

  

1.  Name and Address of Reporting Person*

    Jackson               Don                     L.

2.  Date of Event
     Requiring Statement
     (Month/Day/Year)

    8/1/2002

4.  Issuer Name and Tickler or Trading Symbol

    Mediware Information Systems, Inc.
    MEDW

(Last)                          (First)                      (Middle)

  c/o Mediware Information Systems, Inc.
       11711 West 79th Street

(Street)

  Lenexa                   KS                    66214

3.  I.R.S. Identification
     Number of  Reporting
     Person, if an entity
     (voluntary)

5.  Relationship of Reporting Person(s) to Issuer
       (Check all applicable)

        Director                              ___ 10% Owner
  X    Officer (give title below)    ___ Other 
                                                             (specify below)
   Vice President and General Manager

6.  If Amendment, Date of Original
   (Month/Day/Year)

   

(City)                              (State)                              (Zip)

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 Beneficially Owned

1.Title of Security 
   (Instr. 4)

2.  Amount of Securities
     Beneficially Owned 
     (Instr. 4)

3.  Ownership Form: Direct (D) or  Indirect (I)
     (Instr. 5)

4.  Nature of Indirect Beneficial Ownership
     (Instr. 5)

  Common Stock, Par Value $ .10   0   N/A   N/A
           
           
           
           
           

 

 

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security
    (Instr. 4)

2. Date Exercisable and Expiration Date
    (Month/Day/Year)

3. Title and Amount of Securities Underlying
    Derivative Security
    (Instr. 4)

4.  Conversion or
     Exercise Price of
     Derivative Security

5.  Ownership  Form of Derivative Securities: Direct  (D) or Indirect (I) (Instr. 5)

6.  Nature of Indirect
     Beneficial
     Ownership
      (Instr. 5)

Date Exercisable

Expiration Date

  Title  

Amount or Number of Shares

  Stock Option (Right to Buy)

  (1)

  7/31/07

   Common Stock   50,000   7.325

  D

  N/A

                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       


Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

Explanation of Responses:  

(1) Granted pursuant to 2001 Stock Option Plan.
  Options vest ratably over 3-year period commencing August 1, 2003

 

         

                                   DON L. JACKSON                            
DON L. JACKSON
**Signature of Reporting Person

           12/17/02       

     Date

*

If the form is filed by more than one reporting person, see Instruction 5(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.