-----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, M500P8nWsGPTYZgi24bEd7tQof0TNHaCKcm+eG04iUOxWbdxaPak00yDl+506ajJ 38w3c9AEZf4Mg7HOEWNDPg== 0001025894-02-000173.txt : 20020415 0001025894-02-000173.hdr.sgml : 20020415 ACCESSION NUMBER: 0001025894-02-000173 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020228 FILED AS OF DATE: 20020308 COMPANY DATA: COMPANY CONFORMED NAME: NIERENBERG DAVID CENTRAL INDEX KEY: 0001040899 OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 19605 N E 8TH STREET CITY: CAMAS STATE: WA ZIP: 98607 BUSINESS PHONE: 3606048600 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PEDIATRIC SERVICES OF AMERICA INC CENTRAL INDEX KEY: 0000893430 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 581873345 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23946 FILM NUMBER: 02570922 BUSINESS ADDRESS: STREET 1: 31O TECHNOLOGY PKWY CITY: NORCROSS STATE: GA ZIP: 30092-2929 BUSINESS PHONE: 7704411580 MAIL ADDRESS: STREET 1: 310 TECHNOLOGY PKWY CITY: NORCROSS STATE: GA ZIP: 30092-2929 4 1 n_ps4202.txt FORM 4, PSAI 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 1. Name and Address of Reporting Person* David Nierenberg The D3 Family Fund 19605 NE 8th St. Camas, WA 98607 2. Issuer Name and Ticker or Trading Symbol Pediatric Services of America, Inc. (PSAI.OB) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) N/A 4. Statement for Month/Year 2/28/02 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) / / Director / / Officer (give title below) /X/ 10% Owner / / Other (specify below) N/A ___________________ 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 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Security (Instr. 3) Common Stock 2. Transaction Date(s) (Month/Day/Year) 2/4/02 - 2/27/02 3. Transaction Code (Instr. 8) Code: S V 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) Date Amount(Shares) (A) or (D) Price per share --------- -------------- ---------- --------------- 2/4 8,000 (D) 11.11 2/03 310,000 (D) 11.00 (300,000 by D3, 10,000 by Haredale) 2/14 2,500 (D) 12.54 2/25 32,500 (D) 12.51 2/26 50,000 (D) 12.53 2/27 15,000 (D) 12.56 5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4) 925,230 (15.8%) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) D: 905,230 I: 20,000 By Haredale, Ltd. P.O. Box N-4465, Nassau, New Providence, The Bahamas. 7. Nature of Indirect Beneficial Ownership (Instr. 4) Haredale, Ltd. owns, and Mr. Nierenberg has sole voting and dispositive power over, its 20,000 shares. 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) N/A 2. Conversion or Exercise Price of Derivative Security N/A 3. Transaction Date (Month/Day/Year) N/A 4. Transaction Code (Instr. 8) N/A 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) N/A 6. Date Exercisable and Expiration Date (Month/Day/Year) N/A 7. Title and Amount of Underlying Securities (Instr. 3 and 4) N/A 8. Price of Derivative Security (Instr. 5) N/A 9. Number of Derivative Securities Beneficially Owned at End of Month (Instr. 4) N/A 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) N/A 11. Nature of Indirect Beneficial Ownership (Instr. 4) N/A Explanation of Responses: N/A /s/ DAVID NIERENBERG 3/8/02 ---------------------------------------- ------- ** 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 procedure. Potential person(s) who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. -----END PRIVACY-ENHANCED MESSAGE-----