-----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, L8mA7IfihmPKx4aiy+UGYLsWYeTDydoywONPV6ZnQpkz14lSMdeThf2ueiq2LhUq FTOqnyW5CoXJP/lnbFymJA== 0000950144-02-012341.txt : 20021127 0000950144-02-012341.hdr.sgml : 20021127 20021127101310 ACCESSION NUMBER: 0000950144-02-012341 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020702 FILED AS OF DATE: 20021127 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PER SE TECHNOLOGIES INC CENTRAL INDEX KEY: 0000878556 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 581651222 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-19480 FILM NUMBER: 02842031 BUSINESS ADDRESS: STREET 1: 2840 MT WILKINSON PARKWAY STREET 2: SUITE 300 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: 7704445300 MAIL ADDRESS: STREET 1: 2700 CUMBERLAND PKWY STREET 2: STE 300 CITY: ATLANTA STATE: GA ZIP: 30339 FORMER COMPANY: FORMER CONFORMED NAME: MEDAPHIS CORP DATE OF NAME CHANGE: 19931027 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: POPE JOHN C CENTRAL INDEX KEY: 0001192499 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: 810 S. RIDGE RD CITY: LAKE FOREST STATE: IL ZIP: 60045 BUSINESS PHONE: 8477357230 MAIL ADDRESS: STREET 1: 810 S. RIDGE RD CITY: LAKE FOREST STATE: IL ZIP: 60045 4/A 1 g79597e4za.htm PER-SE TECHNOLOGIES, INC. / JOHN C. POPE PER-SE TECHNOLOGIES, INC. / JOHN C. POPE
 

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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

o 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*
(Last, First, Middle)
2. Issuer Name and Ticker or
Trading Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Pope, John C.
  Per-Se Technologies, Inc. (PSTI)
 
  810 South Ridge Road
4. Statement for (Month/Day/Year) 5. If Amendment, Date of Original (Month/Day/Year)
    June 2002
  July 2, 2002*
  (Street) 6. Relationship of Reporting Person(s) to Issuer (Check All Applicable) 7. Individual or Joint/Group Filing
(Check Applicable Line)
  Lake Forest, IL 60045
(City)                (State)           (Zip)
  x  Director o  10% Owner   x Form filed by One Reporting Person
    o  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)  
       
     

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).
 

 


 


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
Transactions(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, $.01 par value per share   6/03/02   A V   1,563.65 (1)   A (2) $10.87 (3)     28,875.86     D  

                     

                     

                     

                     

                     

                     

                   

                   

                   

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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)

                      Code V   (A) (D)

             

             

             

             

             

             

             

             

             

             

Page 3


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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 of
Derivative Security:
Direct (D) or Indirect (I)

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

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

                 

                 

                 

                 

                 

                 

                 

                 

                 

                 

Explanation of Responses:

(1) Represented by deferred "stock units" (phantom stock) credited under the Per-Se Technologies, Inc. Deferred Stock Unit Plan (the "Plan"). The stock units are to be settled in Common Stock on a 1-for-1 basis, in one installment as soon as administratively feasible following the date on which the Reporting Person ceases to be a Director of the Issuer, with any fractional shares payable in cash.

(2) Reflects deferral under the Plan and conversion into stock units of $17,000, comprising 100% of the Reporting Person's cash compensation otherwise payable for Board and Committee service during the period from February 3, 2002, through May 1, 2002 (the 4th Quarter of the 2001-02 Board Year).

(3) Average closing price of the Common Stock for the five business days prior to June 3, 2002, the date on which the stock units were credited to the Reporting Person's account under the Plan.

* This Amendment reflects the deferral and conversion into stock units of an additional $1,000, resulting in an additional 91.98 stock units, inadvertently omitted from the Statement for June 2002.

/s/ JOHN C. POPE   November 26, 2002

**Signature of Reporting Person
 
Date


**   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.
 

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