-----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, Alw3dj2qQqq9MpTLzZa4aJQgQgwTFNlqsCS4e0l72ZHhe6iM7L7NOFH2oIYSHfMh yEoCDqSZd574X+XUPz3JDg== 0000920527-05-000080.txt : 20051116 0000920527-05-000080.hdr.sgml : 20051116 20051116153145 ACCESSION NUMBER: 0000920527-05-000080 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051115 FILED AS OF DATE: 20051116 DATE AS OF CHANGE: 20051116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH DAVID A CENTRAL INDEX KEY: 0001183759 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23832 FILM NUMBER: 051209754 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: 0331 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 2005-11-15 0000920527 PSS WORLD MEDICAL INC PSSI 0001183759 SMITH DAVID A 24566 HARBOUR VIEW DR. PONTE VEDRA BEACH FL 32082 0 1 0 0 President and CEO Common Stock 2005-11-15 4 M 0 25000 2.97 A 147956 D Common Stock 2005-11-15 4 S 0 13295 13.9569 D 134661 D Common Stock 18801 I by 401(k) Plan Non Qualified Stock Option (right to buy) 2.97 2005-11-15 4 M 0 25000 0 D 2001-11-21 2005-11-21 Common Stock 25000 0 D The sale reported in this Form 4 was effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on November 1, 2005. 401(k) - PSS World Medical, Inc. 401(k) Savings Plan Shares were calculated by taking the balance of the Stock Fund on November 15, 2005 and dividing by the closing price on November 15, 2005. $263,215.81 / 14.00 = 18,801 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 2005-11-16 -----END PRIVACY-ENHANCED MESSAGE-----