4 1 carlanderform4.htm CARL ANDERSON

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 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(f) of the Investment Company Act of 1940

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5

obligations may continue. See Instruction 1(b).

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1. Name and Address of Reporting Person**

 

   Anderson, Jr.        Carl            G.

-------------------------------------------------------------------------         (Last)            (First)    (Middle)

 

   2400 Bernville Road

------------------------------------------------------------------------ (Street)

 

    Reading    PA   19605

------------------------------------------------------------------------    (City)  (State)   (Zip)

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2. Issuer Name and Ticker or Trading Symbol

Arrow International, Inc. (ARRO)

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

 

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4. Statement for Month/Year

01/02

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

 

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6. Relationship of Reporting Person(s) to Issuer

(Check all applicable)

[X] Director [ ] 10% Owner

[X] Officer (give title below) [ ] Other (specify below)

 

Vice Chairman of the Board and General Manager, Critical Care Business

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7. Individual or Joint/Group Filing (Check Applicable Line)

[ X ] Form filed by One Reporting Person

[ ] Form filed by More than One Reporting Person

 

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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1.Title of Security (Instr. 3)

2.Trans- action Date (mm/dd/yy)

3.Trans- action Code (Instr. 8)

4.Securities Acquired (A) or disposed of (D)(Instr. 3 and 4)

5.Amount of Securities Beneficially Owned at End of Month(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

 

 

  

 

 

 

 

 

 

 
   

 

       

 

 

 

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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).

 

FORM 4 (continued)

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Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned

(e.g., puts, calls, warrants, options, convertible securities)

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1.Title of Derivative  Security (Instr. 3)

2.Conversion or Exercise Price of Derivative Security

3.Trans- action  Date Month/Day Year

4.Trans- action Code (Instr. 8)

5.Number of Derivative Securities Acquired (A) or (D) Disposed of Instr. 3,4,5

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

7.Title and Amount of Underlying Securities

Code V (A) (D)

Date Exer- cisable *

Expir- ation Date  

Title

Amount or num- ber of Shares
Employee Stock Option (right to buy)  41.24  1/16/2002  A  V  75,000    1/16/2003  1/16/2012    75,000
                     
                     
                     

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8.Price of Derivative Security (Instr. 5)

9.Number of Derivative Securities Beneficially Owned at End of Month (Instr. 4)

10.Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)

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

   75,000

 D

 
       
       
       

*20% on the first anniversary of the date of the grant; an additional 20% of shares on each of the second through fifth anniversaries of the date of the grant. 

Explanation of Responses:

 

 

 /s/Carl G. Anderson, Jr.      February 8, 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 provided is insufficient, see Instruction 6 for procedures.

 

Alternatively, this Form is permitted to be submitted to the

Commission in electronic format at the option of the reporting person

pursuant to Rule 101(b)(4) of Regulation S-T.