4/A 1 y43433ae4a.txt AMENDMENT TO FORM 4 1 Page 1 of 4 OMB APPROVAL ------------------------- OMB Number: 3235-0287 ------------------------- Expires: October 31, 2001 ------------------------- Estimated average burden hours per response...0.5 ------------------------- FORM 4/A 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 [_] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Commonwealth Associates, LP -------------------------------------------------------------------------------- (Last) (First) (Middle) 830 Third Avenue -------------------------------------------------------------------------------- (Street) New York New York 10022 -------------------------------------------------------------------------------- (City) (State) (Zip) ______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol ProxyMed, Inc. (NASDAQ National Market:PILL) -------------------------------------------------------------------------------- ________________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person, if an entity (Voluntary) 13-3467952 ________________________________________________________________________________ 4. Statement for Month/Year November 2000 --------------------------------------------------------------------------- ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) December 2000 ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) Michael S. Falk is a director ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable Line) [_] Form filed by One Reporting Person [X] Form filed by More than One Reporting Person ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (Month/Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/20/00 P 5,000 A $0.96875 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/21/00 P 5,000 A $1.00 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/21/00 P 5,000 A $1.01 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/21/00 P 30,000 A $0.985 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/21/00 P 10,000 A $0.96875 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/22/00 P 20,000 A $1.01 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/22/00 P 25,000 A $0.98 122,666 D(1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 62,500 I (2) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
2 FORM 4 (continued) Page 2 of 4 Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: See Attached
Commonwealth Associates L.P. By: Commonwealth Associates Management Corp., its general partner /s/ Joseph P. Wynne December 8, 2000 --------------------------------------------- ----------------------- **Signature of Reporting Person Date Joseph P. Wynne, Chief Financial Officer Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 4(b)(v). ** 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 persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a current valid OBM Number. 2 of 2 3 Page 3 of 4 FOOTNOTES --------- (1) These shares were acquired, and are owned directly by, Commonwealth Associates, L.P. ("Commonwealth") . Michael S. Falk ("Falk") is the principal limited partner of Commonwealth, and is a director, the Chairman and the principal shareholder of Commonwealth Associates Management Corp., the general partner of Commonwealth. Falk disclaims beneficial ownership of the securities held by Commonwealth other than that portion which corresponds with his equity ownership in Commonwealth. (2) These shares are owned directly by Falk. 4 Page 4 of 4 JOINT FILER INFORMATION AND AUTHORIZATION ----------------------------------------- Name: Commonwealth Associates Management Corp. 830 Third Avenue New York, New York 10022 Designated Filer: Commonwealth Associates, LP Issuer & Ticker Symbol: ProxyMed, Inc. (PILL) Statement Month/Year: November 2000 Signature: By: /s/ Joseph Wynne ------------------------------------------- Joseph Wynne, Chief Financial Officer Name: Michael S. Falk 830 Third Avenue New York, New York 10022 Designated Filer: Commonwealth Associates, LP Issuer & Ticker Symbol: ProxyMed, Inc. (PILL) Statement Month/Year: November 2000 Signature: /s/ Michael S. Falk ----------------------- Michael S. Falk