-----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, BsmZV5xAxb+EKDGOGOpz7Y73d83bgrwNE9UkDZDyk5bxfUlIXSUy+DyxA44080jm 10/DOixIdPvlFWVWkHuPog== 0000898430-99-001856.txt : 19990506 0000898430-99-001856.hdr.sgml : 19990506 ACCESSION NUMBER: 0000898430-99-001856 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990401 FILED AS OF DATE: 19990505 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: TOTAL RENAL CARE HOLDINGS 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: 99610529 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 INC DATE OF NAME CHANGE: 19940719 COMPANY DATA: COMPANY CONFORMED NAME: ANDERSONS MARIS CENTRAL INDEX KEY: 0001069422 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 STATEMENT OF CHANGES TO BENEFICIAL OWNERSHIP /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0287 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Andersons Maris - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Total Renal Care Holdings, Inc. 21250 Hawthorne Blvd. - -------------------------------------------------------------------------------- (Street) Torrance CA 90503 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Total Renal Care Holdings, Inc.(TRL) ------------------------------------ 3. IRS or Identification Number of Reporting Person if an entity (Voluntary) -------------- 4. Statement for Month/Year 4/99 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) ---------------------------------------------------------------- 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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 04/01/99 M 13,889 A $0.90 19,777 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If this form is filed by more than one reporting person, see Instruction 4(b)(v). 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 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- Options (16b-3 Plan) $0.90 4/01/99 M 13,889 - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- Options (16b-3 Plan) $9 13/16 4/08/99 A V 25,000 - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -----------------------------------------------------------------------------------------------------------------------------
TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)--CONTINUED
- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of In- Date ative Secur- of De- direct (Month/Day/ Secur- ities rivative Bene- Year) ity Bene- Secu- ficial (Instr. ficially rity: Owner- -------------------------------------------- 5) Owned Direct ship Date Expira- Amount or at End (D) or (Instr. Exer- tion Title Number of of Indi- 4) cisable Date Shares Month rect (1) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ (1) 4/01/05 Common Stock 13,889 0 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ (1) 4/08/09 Common Stock 25,000 25,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Twenty-five percent of the options vest each year on the anniversary of the date of grant. **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 currently valid OMB Number. /s/ Maris Andersons May 4, 1999 ------------------------------- ------------- **Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----