-----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, Cn5387DINgFL4eKge79n0zT6c4LT+qHYEfuJyap4plYPP/wn+qS7hfAVxdMtoDhh 6RZNcfpEbJUSTZ2rucv2xQ== 0000898430-01-001312.txt : 20010411 0000898430-01-001312.hdr.sgml : 20010411 ACCESSION NUMBER: 0000898430-01-001312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010327 FILED AS OF DATE: 20010410 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: DAVITA INC CENTRAL INDEX KEY: 0000927066 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 510354549 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-04034 FILM NUMBER: 1598573 BUSINESS ADDRESS: STREET 1: 21250 HAWTHORNE BLVD STREET 2: SIE 800 CITY: TORRANCE STATE: CA ZIP: 90503-5517 BUSINESS PHONE: 3107922600 MAIL ADDRESS: STREET 1: 21250 HAWTHORNE BLVD SUITE 800 STREET 2: 21250 HAWTHORNE BLVD SUITE 800 CITY: TORRANCE STATE: CA ZIP: 90503-5517 FORMER COMPANY: FORMER CONFORMED NAME: TOTAL RENAL CARE HOLDINGS INC DATE OF NAME CHANGE: 19950524 FORMER COMPANY: FORMER CONFORMED NAME: TOTAL RENAL CARE INC DATE OF NAME CHANGE: 19940719 COMPANY DATA: COMPANY CONFORMED NAME: MASSRY SHAUL G CENTRAL INDEX KEY: 0001069431 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] DIRECTOR STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: TOTAL RENAL CARE HOLDINGS INC STREET 2: 21250 HAWTHORNE BLVD STE 800 CITY: TORRANCE STATE: CA ZIP: 90503 BUSINESS PHONE: 3107922600 4 1 0001.txt FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 OMB APPROVAL ----------------------------- [_] Check this box if no longer OMB NUMBER: 3235-0287 subject to Section 16. Form 4 Expires: December 31, 2001 or Form 5 obligations may Estimated average burden continue. SEE Instruction 1(b). hours per response ...... 0.5 ----------------------------- 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 1. Name and Address of Reporting Person Massry, M.D. Shaul - -------------------------------------------------------------------------------- (Last) (First) (Middle) 21250 Hawthorne Blvd, Suite 800 - -------------------------------------------------------------------------------- (Street) Torrance, CA 90503 - -------------------------------------------------------------------------------- (City) (State) (Zip) DaVita Inc. (DVA) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) 3/2001 - -------------------------------------------------------------------------------- 4. Statement for Month/Year - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) X Director 10% Owner ----- ------ Officer (give Other (Specify ----- title below) ------ below) ---------------------------------- - -------------------------------------------------------------------------------- 7. Individual or Group (Check Applicable Line) X Form filed by One Reporting Person --- ___ First filed by More than One Reporting Person
Table 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature (Instr. 3) action action or Disposed of (D) Securities Form: of Indirect Date Code Beneficially Direct Beneficial (Instr. 8) (Instr. 3,4 and 5) Owned at (D) or Ownership (Month/ ------------ -------------------------- End of Month Indirect (Instr. 4) Day/ Code V Amount (A) or Price (Instr. 3 (I) Year) (D) and 4) (Instr. 4) - -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ -------- -------------- ------------ ------------- Common Stock 3/27/01 M 10,000 A $9.0625 D - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ ------------- Common Stock 3/27/01 M 11,112 A $ .90 D - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ ------------- Common Stock 3/27/01 M 11,250 A $ 7.125 D - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ ------------- Common Stock 3/27/01 S 32,362 D $16.475 3,900 D - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ ------------- - -------------------------- ---------- ------ ---- -------- ------ ------- -------------- ------------ -------------
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(o)(v). Potential person(s) who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. (Over) SEC 1474 (3-99) FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security 2. Conversion 3. Transaction 4. Transaction 5. Number of Derivative 6. Date Exercisable (Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date Derivative Year) (Instr. 3, 4, and 5) (Month/Day/Year) Security --------------- -------------------------- ------------------- Code V (A) (D) Date Expiration Exer- Date cisable - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- Options (16b-3 Plan) $9.0625 3/27/01 M 10,000 (1) 6/12/01 - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- Options (16b-3 Plan) $ .90 3/27/01 M 11,112 (2) 6/12/01 - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- Options (16b-3 Plan) $ 7.125 3/27/01 M 11,250 (3) 6/12/01 - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ---------- - ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership (Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4) Instr. 4) Indirect (I) (Instr. 4) - ------------------------ Title Amount or Number of Shares - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ Common Stock 10,000 10,000 D - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ Common Stock 11,112 11,112 D - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ Common Stock 11,250 11,250 D - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------ - ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
Explanation of Responses: 1. 5,000 of the indicated options vested on March 11, 1999 and 5,000 vested on March 11, 2000. 2. 5,556 options vested on December 20, 1995 and 5,556 vested on December 20, 1996. 3. 5,000 of the indicated options vested on October 1, 1999 and 5,000 vested on October 1, 2000. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Shaul Massry, M.D. 4/10/01 ------------------------------- -------------- **Signature of Reporting Person Date 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 person(s) who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 SEC 1474 (3-99) -----END PRIVACY-ENHANCED MESSAGE-----