-----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, DsjpflUGUoLeYgyWP4mqUn/L7p9lKrRRfvo6qztGtiTBMVKFhCVjc5xLx1i+47Qf 9BM+Jw7hyct9ep/r6yg36g== /in/edgar/work/20000828/0000906337-00-000030/0000906337-00-000030.txt : 20000922 0000906337-00-000030.hdr.sgml : 20000922 ACCESSION NUMBER: 0000906337-00-000030 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000728 FILED AS OF DATE: 20000828 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PROXYMED INC /FT LAUDERDALE/ CENTRAL INDEX KEY: 0000906337 STANDARD INDUSTRIAL CLASSIFICATION: [7374 ] IRS NUMBER: 650202059 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-22052 FILM NUMBER: 710641 BUSINESS ADDRESS: STREET 1: 2555 DAVIE ROAD STREET 2: SUITE 110 CITY: FORT LAUDERDALE STATE: FL ZIP: 33317-7424 BUSINESS PHONE: 9544731001 FORMER COMPANY: FORMER CONFORMED NAME: HMO PHARMACY INC DATE OF NAME CHANGE: 19930601 COMPANY DATA: COMPANY CONFORMED NAME: HOOVER MICHAEL K CENTRAL INDEX KEY: 0001122501 STANDARD INDUSTRIAL CLASSIFICATION: [ ]DIRECTOR STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 820 HEDGEGATE COURT CITY: ROSWELL STATE: GA ZIP: 30075 BUSINESS PHONE: 9544731001 3 1 0001.txt FORM 3 - 07/28/00 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person Hoover, Michael K 820 Hedgegate Court Roswell, GA 30075 USA 2. Date of Event Requiring Statement (Month/Day/Year) 07/28/00 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol ProxyMed, Inc. PILL 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Chairman and Chief Executive Officer 6. If Amendment, Date of Original (Month/Day/Year) 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 |2. Amount of |3. Ownership |4. Nature of Indirect | | Securities | Form: | Beneficial Ownership | | Beneficially | Direct(D) or | | | Owned | Indirect(I) | | ___________________________________________________________________________________________________________________________________| Common Stock, par value $.001 (Restricted) |200,000** |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Date Exer- |3.Title and Amount | |4. Conver-|5. Owner- |6. Nature of Indirect | Security | cisable and | of Underlying | |sion or |ship | Beneficial Ownership | | Expiration | Securities | |exercise |Form of | | | Date(Month/ |-----------------------|---------|price of |Deriv- | | | Day/Year) | |Amount |deri- |ative | | | Date | Expira- | |or |vative |Security: | | | Exer- | tion | Title |Number of|Security |Direct(D) or | | | cisable | Date | |Shares | |Indirect(I) | | ___________________________________________________________________________________________________________________________________| Series C 7% Convertible |** |N/A |Pref. convertible into |1,000,000|$1.00 |D | | Preferred Stock | | |Common w/optional & man| | | | | | | |datory conversion right| | | | | | | |s | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Warrants |** |08/17/05 |Common Stock, par value|500,000 |$1.00*** |D | | | | | $.001 | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Options |** |07/28/10 |Common Stock, par value|1,666,667|$1.50 |D | | | | | $.001 | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Options |07/28/02*|07/28/10 |Common Stock, par value|1,666,667|$1.50 |D | | |* | | $.001 | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Options |07/28/03 |07/28/10 |Common Stock, par value|1,666,666|$1.50 |D | | | | | $.001 | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: **Conversion Shares, Warrant Shares and Stock Options are subject to a 15-month lockup from the date of issuance or grant, which may be extended an additional 12 months at the discretion of the Issuer. ***Subject to anti-dilution adjustments as provided in the Warrant. SIGNATURE OF REPORTING PERSON Michael K. Hoover DATE August 28, 2000 -----END PRIVACY-ENHANCED MESSAGE-----