Palomar Medical Technologies Inc - Statement of Changes in Beneficial Ownership (4)
05 3월 2008 - 7:12AM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Expires:
January 31, 2008
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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
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1. Name and Address of Reporting Person
*
COHANE JEANNE
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2. Issuer Name
and
Ticker or Trading Symbol
PALOMAR MEDICAL TECHNOLOGIES INC
[
PMTI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
82 CAMBRIDGE STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/29/2008
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(Street)
BURLINGTON, MA 01803
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Non-Qualified Stock Option (right to buy)
(1)
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$13.31
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2/29/2008
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A
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10000
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2/29/2008
(2)
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2/27/2018
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Common Stock
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10000
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$0
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10000
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D
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Non-Qualified Stock Option (right to buy)
(1)
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$16.53
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2/29/2008
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J
(3)
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10000
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(4)
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(5)
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Common Stock
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10000
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$0
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0
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D
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Explanation of Responses:
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(
1)
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2004 Incentive Stock Plan
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(
2)
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The stock option is fully exercisable on the grant date.
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(
3)
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Options did not vest and therefore were cancelled due to The Gillette Company terminating the Gillette Agreement prior to making the "Launch Decision", as that term is defined in the Development and License Agreement between Palomar and The Gillette Company effective as of February 14, 2003, including any amendments.
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(
4)
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The stock option becomes exercisable on the date a "Launch Decision" is made, as that term is defined in the Development and License Agreement between Palomar and The Gillette Company effective as of February 14, 2003, including any amendments.
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(
5)
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The stock option shall expire if the Gillette Agreement is terminated prior to a Launch Decision being made but in any event, no later than 5/11/14.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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COHANE JEANNE
82 CAMBRIDGE STREET
BURLINGTON, MA 01803
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X
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Signatures
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By: Paul S. Weiner For: Jeanne Cohane
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3/4/2008
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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