-----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, NOJZe8Vvt4+MFmun+cO/R7WcJJZO9SDdfy+ZGE0JWKo3XFkuvaWbWeKXrqaXcAL6 r2sMrdw/NkRf0kCzEgU8JA== 0000920527-04-000090.txt : 20041201 0000920527-04-000090.hdr.sgml : 20041201 20041201155433 ACCESSION NUMBER: 0000920527-04-000090 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041130 FILED AS OF DATE: 20041201 DATE AS OF CHANGE: 20041201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CORELESS GARY A CENTRAL INDEX KEY: 0001183761 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23832 FILM NUMBER: 041177530 BUSINESS ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD. CITY: JACKSONVILLE STATE: FL ZIP: 32216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PSS WORLD MEDICAL INC CENTRAL INDEX KEY: 0000920527 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 592280364 STATE OF INCORPORATION: FL FISCAL YEAR END: 0329 BUSINESS ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 BUSINESS PHONE: 9043323000 MAIL ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 FORMER COMPANY: FORMER CONFORMED NAME: PHYSICIAN SALES & SERVICE INC /FL/ DATE OF NAME CHANGE: 19940318 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-11-30 0000920527 PSS WORLD MEDICAL INC PSSI 0001183761 CORELESS GARY A 3741 SALT MEADOW CT. S. JACKSONVILLE FL 32224 0 1 0 0 President, PSS Common Stock 2004-11-30 4 M 0 15000 2.97 A 35502 D Common Stock 2004-11-30 4 S 0 15000 12.5323 D 20502 D Common Stock 7269 I by 401(k) Plan Non Qualified Stock Option (right to buy) 2.97 2004-11-30 4 M 0 15000 0 D 2001-11-21 2005-11-21 Common Stock 15000 10000 D 401(k) - PSS World Medical, Inc. 401(k) Savings Plan Shares were calculated by taking the balance of the Stock Fund on 11/30/04 and dividing by the closing price on 11/30/04. $90,936.92 / 12.51 = 7,269 shares. The option vested in three equal annual installments on November 21, 2001, November 21, 2002 and November 21, 2003. Mark Rotondaro, attorney-in-fact 2004-12-01 -----END PRIVACY-ENHANCED MESSAGE-----