-----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, QhkI2l72Ldb9fYiEFW9LbK/yMh4ZRBxrmEEF8ys4ZijG7b9jum+P+rsj7O27mqEX l18/qFanFn/o/8R1OIt49w== 0000906337-99-000033.txt : 19991213 0000906337-99-000033.hdr.sgml : 19991213 ACCESSION NUMBER: 0000906337-99-000033 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991126 FILED AS OF DATE: 19991210 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: 3 SEC ACT: SEC FILE NUMBER: 000-22052 FILM NUMBER: 99772748 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: OKKERSE JOHN B JR CENTRAL INDEX KEY: 0001100033 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR IRS NUMBER: 650202059 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 2555 DAVIE ROAD SUITE 110 CITY: FORT LAUDERDALE STATE: FL ZIP: 33317 BUSINESS PHONE: 8544731001 MAIL ADDRESS: STREET 1: 2555 DAVIE ROAD SUITE 110 CITY: FORT LAUDERDALE STATE: FL ZIP: 33317 3 1 FORM 3 - 11/26/99 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 Okkerse, John Jr. B 2555 Davie Road, Suite 110 Fort Lauderdale, FL 33317 USA 2. Date of Event Requiring Statement (Month/Day/Year) 11/26/99 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) 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) | | ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ 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) | | ___________________________________________________________________________________________________________________________________| Employee Stock Option |11/26/00 |11/26/09 |Common Stock |100,000 |$10.25 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Option |11/26/01 |11/26/09 |Common Stock |100,000 |$10.25 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Option |11/26/02 |11/26/09 |Common Stock |100,000 |$10.25 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: SIGNATURE OF REPORTING PERSON John B. Okkerse, Jr. DATE December 1, 1999 -----END PRIVACY-ENHANCED MESSAGE-----