4 1 file001.txt FORM 4 -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION FORM 4 WASHINGTON, DC 20549 -------- STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 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 -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Aitken, Timothy M. -------------------------------------------------------------------------------- (Last) (First) (Middle) Allied Healthcare International Inc. 555 Madison Avenue, 30th Floor -------------------------------------------------------------------------------- (Street) New York, New York 10022 -------------------------------------------------------------------------------- (City) (State) (Zip) -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Allied Healthcare International Inc. (ADH) -------------------------------------------------------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) -------------------------------------------------------------------------------- 4. Statement for Month/Day/Year December 6, 2002 -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Day/Year) -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Chairman of the Board and Chief Executive Officer -------------------------------------------------------------------------------- 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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 5. Amount of 6. 4. Securities Owner- 2. Securities Acquired (A) or Beneficially ship Trans- 2A. 3. Disposed of (D) Owned Form: 7. action Deemed Transaction (Instr. 3, 4 and 5) Following Direct Nature of Date Execution Code ----------------------------- Reported (D) or Indirect 1. (Month/ Date, if (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Day/ any (Month/ ------------ or (Instr. 3 (I) Ownership (Instr. 3) Year) Day/Year) Code V Amount (D) Price and 4) (Instr.4) (Instr.4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/6/02 J(1) 11,367 A $9.03(1) 715,625(2) D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/6/02 J(1) 11,366 A $9.03(1) 11,366 I (3) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
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TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 9. Number 10. of Owner- Deriv- ship ative Form 2. Secur- of Conver- 5. 7. ities Deriv- 11. sion Number of Title and Amount Bene- ative Nature or 3A. Derivative 6. of Underlying 8. ficially Secur- of Exer- Deemed 4. Securities Date Securities Price Owned ities: In- cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Follow- Direct direct Price Trans- tion action or Disposed Expiration Date ---------------- Deriv- ing (D) or Bene- 1. of action Date, Code of (D) (Month/Day/Year) Amount ative Reported In- ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- Trans- direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity action(s) (I) ship Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Right to Funding Note (right to acquire Funding Note representing the right to acquire Common Stock) held by Mr. Common Aitken $0.00(1) 12/6/02 J(I) 11,367 7/25/02 None Stock 11,367 0 ------------------------------------------------------------------------------------------------------------------------------------ Right to Funding Note (right to acquire Funding Note representing the right to acquire Common Stock) held by Aitken (English) Company Common Limited $0.00(1) 12/6/02 J(I) 11,366 7/25/02 None Stock 11,366 0 ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) On July 25, 2002, Allied Healthcare International Inc. (the "Company") consummated a reorganization (the "Reorganization") involving the Company and two of its U.K. subsidiaries, Allied Healthcare Group Limited ("Allied Healthcare (UK)") and Transworld Healthcare (UK) Limited ("TWUK"). The net effect of the Reorganization was that TWUK became a wholly-owned subsidiary of the Company and all of the senior subordinated promissory notes (the "Promissory Notes") of Allied Healthcare (UK) were replaced by Series A Convertible Preferred Stock of the Company. The Reorganization was effected pursuant to a Reorganization Agreement (the "Reorganization Agreement"), dated as of April 24, 2002, as amended on May 16, 2002 and June 26, 2002, among the Company, Allied Healthcare (UK), TWUK and certain other persons. In the Reorganization, Mr. Aitken and Aitken (English) Company Limited, an affiliate of Mr. Aitken, were issued shares of Series A Convertible Preferred Stock of the Company in exchange for the principal amount of their Promissory Notes. In addition, as a result of the consummation of the Reorganization and pursuant to the provisions of the Reorganization Agreement, accrued and unpaid payment-in-kind ("PIK") interest through June 17, 2002 in the amount of (pound sterling) 65,176 (approximately $102,678 as of July 25, 2002) on the Promissory Notes held by each of Mr. Aitken and Aitken (English) Company Limited were exchanged for shares of Common Stock of the Company in accordance with the following procedure: (a) PIK interest on the Promissory Notes ceased to accrue as of June 17, 2002, the date specified in the Reorganization Agreement; (b) Allied Healthcare (UK) was obligated to issue to each of Mr. Aitken and Aitken (English) Company Limited a funding note ("Funding Note") in the principal amount of the accrued PIK interest on their Promissory Notes through June 17, 2002; and (c) when issued, each Funding Note was exchanged for shares of Common Stock of the Company at a ratio of 0.3488 shares of Common Stock for every (pound sterling) 2.00 in principal amount of Funding Note. In accordance with the foregoing, on December 6, 2002, Allied Healthcare (UK) issued Mr. Aitken a Funding Note in the principal amount of (pound sterling) 65,176 (approximately $102,678 as of July 25, 2002) and, on the same date, such Funding Note was exchanged for 11,367 shares of Common Stock. As a result of the foregoing, Mr. Aitken exchanged (pound sterling) 65,176 (approximately $102,678 as of July 25, 2002) in PIK interest for 11,367 shares of Common Stock of the Company, resulting in a purchase price of $9.03 per share of Common Stock. In addition, on December 6, 2002, Allied Healthcare (UK) issued Aitken (English) Company Limited a Funding Note in the principal amount of (pound sterling) 65,176 (approximately $102,678 as of July 25, 2002) and, on the same date, such Funding Note was exchanged for 11,366 shares of Common Stock. As a result of the foregoing, Aitken (English) Company Limited exchanged (pound sterling)65,176 (approximately $102,678 as of July 25, 2002) in PIK interest for 11,366 shares of Common Stock of the Company, resulting in a purchase price of $9.03 per share of Common Stock. (2) Excludes 905,000 shares of Common Stock subject to options held by Mr. Aitken, 845,000 of which are exercisable as of the date hereof, and 87,200 shares of Common Stock issuable upon conversion of the 87,200 shares of Series A Convertible Preferred Stock of the Company held by Mr. Aitken. Also excludes 11,366 shares of Common Stock held by Aitken (English) Limited, an affiliate of Mr. Aitken and 87,200 shares of Common Stock issuable upon the conversion of the 87,200 shares of Series A Convertible Preferred Stock of the Company held by Aitken (English) Company Limited. (3) By Aitken (English) Company Limited, an affiliate of Mr. Aitken. /s/ Timothy M. Aitken December 9, 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).