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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who 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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 2,936 | 11/13/2001 | 11/13/2011 | Common Stock | 2,936 | $ 0 | 70,064 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 64 | 11/13/2001 | 11/13/2011 | Common Stock | 64 | $ 0 | 70,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 2,000 | 11/13/2001 | 11/13/2011 | Common Stock | 2,000 | $ 0 | 68,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 1,000 | 11/13/2001 | 11/13/2011 | Common Stock | 1,000 | $ 0 | 67,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 1,000 | 11/13/2001 | 11/13/2011 | Common Stock | 1,000 | $ 0 | 66,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 1,000 | 11/13/2001 | 11/13/2011 | Common Stock | 1,000 | $ 0 | 65,000 (3) | D | ||||
Employee Stock Option (right to buy) | $ 3.75 | 08/01/2005 | M(1) | 1,000 | 11/13/2001 | 11/13/2011 | Common Stock | 1,000 | $ 0 | 64,000 (3) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
PEAD PHILIP M 1145 SANCTUARY PARKWAY SUITE 200 ALPHARETTA, GA 30004 |
X | Chairman, President and CEO |
/s/ PHILIP M. PEAD | 08/01/2005 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The transactions reported, which consist of the exercise of an aggregate of 9,000 employee stock options and the concurrent sale of the underlying shares of common stock, were effected pursuant to a trading plan adopted by the Reporting Person pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. (This is the fourth tranche of 9,000 options exercised and shares sold under that plan.) |
(2) | Includes 17,948 deferred stock units credited to the Reporting Person's account under the Per-Se Technologies, Inc. Deferred Stock Unit Plan, and 966 shares credited to the Reporting Person's account under the Per-Se Technologies, Inc. Employees' Retirement Savings Plan (the Per-Se 401(k) plan); does not include 2,716 shares of Common Stock held by family members, for which the Reporting Person disclaims beneficial ownership. |
(3) | Does not include an additional 1,454,998 employee stock options granted on other dates and having different terms, including different exercise prices. |