-----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, JCgrrewLt3uiepdnY+LzR7vGM57YuWn45gd6ZeWcjOralSrPBnqEVWnzqKVzVqD6 s0xElg4SdBpe3/YhudukNA== 0000906337-02-000002.txt : 20020413 0000906337-02-000002.hdr.sgml : 20020413 ACCESSION NUMBER: 0000906337-02-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020108 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PROXYMED INC /FT LAUDERDALE/ CENTRAL INDEX KEY: 0000906337 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 650202059 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22052 FILM NUMBER: 2503604 BUSINESS ADDRESS: STREET 1: 2555 DAVIE ROAD STREET 2: SUITE 110 CITY: FORT LAUDERDALE STATE: FL ZIP: 33317-7424 BUSINESS PHONE: 9544731001 MAIL ADDRESS: STREET 1: 2555 DAVIE ROAD STREET 2: SUITE 110 CITY: FT LAUDERDALE STATE: FL ZIP: 33317 FORMER COMPANY: FORMER CONFORMED NAME: HMO PHARMACY INC DATE OF NAME CHANGE: 19930601 COMPANY DATA: COMPANY CONFORMED NAME: HARDY A THOMAS CENTRAL INDEX KEY: 0001120713 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER IRS NUMBER: 650202059 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 12507 HUMMINGBIRD WAY CITY: SELLERSBURG STATE: IN ZIP: 47172 BUSINESS PHONE: 9544731001 MAIL ADDRESS: STREET 1: 12507 HUMMINGBIRD WAY CITY: SELLERBURG STATE: IN ZIP: 47172 4 1 edgar.txt FORM 4 - 12/31/2001 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 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 Instructions 1(b). 1. Name and Address of Reporting Person Hardy, A. Thomas c/o 2555 Davie Road, Suite 110 Fort Lauderdale, FL 33317 USA 2. Issuer Name and Ticker or Trading Symbol ProxyMed, Inc. PILL 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 12/31/2001 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Senior Vice Pres., Laboratory Services 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 | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | | Transaction | or Disposed of (D) | Securities |ect | Beneficial Ownership | | | | | Beneficially |(D)or | | | | | | | A/| | Owned at |Indir | | | Date |Code|V| Amount | D | Price | End of Month |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock, $.001 par val|12/26/|C |V|22,988* |A |$13.05* |41,142** |D | | ue |01 | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con- |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction | rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |Price of| | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva- | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu- | | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity |Date |Code|V| Amount | |ble | | | |Month |(I)| | ___________________________________________________________________________________________________________________________________| Series C 7% Conv. Pref|$13.05 |12/26|C |V|20,000** |D |09/15|N/A |Common Stock|20,000*|$15.00*|52,091** |D | | erred Stock | |/01 | | | | |/01 | | |* |* | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | ___________________________________________________________________________________________________________________________________|
Explanation of Responses: *Issued as a result of Reporting Person's participating in a Conversion Offering dated 12/12/01 applicable to holders of Series C 7% Convertible Preferred Stock. A total of 2,988 of these shares are restricted securities unless or until such time as the shares are registered. **Adjusted to reflect the 1-for-15 reverse stock split on 8/21/01. Amount of Securities Beneficially Owned at End of Month also includes dividend shares acquired since last report. SIGNATURE OF REPORTING PERSON A. Thomas Hardy DATE January 8, 2002
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