FORM 4 |
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION |
OMB APPROVAL |
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
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(h) of the Investment Company Act of 1940 |
OMB
Number: 3235-0287 Filed By |
1. Name and Address of Reporting Person* Grant II, W. Thomas |
2. Issuer Name and
Ticker or Trading Symbol |
6. Relationship of
Reporting Person(s) Chairman of the Board of Directors, President, Chief Executive Officer and Director |
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(Last) (First) (Middle) 10101 Renner Blvd. |
3. I.R.S. Identification
Number
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4. Statement for Month/Day/Year January 1, 2003 |
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(Street) Lenexa, KS 66219 |
5. If Amendment, Date of Original (Month/Day/Year) |
7. 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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(City) (State) (Zip) |
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security |
2. Trans- |
2A. Deemed |
3. Trans- |
4. Securities Acquired
(A) or Disposed of (D) |
5. Amount of |
6. Owner- |
7. Nature of Indirect
|
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Code |
V |
Amount |
(A) |
Price |
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(b)(v). 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 |
FORM 4 (continued) |
Table II -
Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Derivative
Security |
2. Conver- |
3. Trans- |
3A. Deemed Execution Date, if any (Month/ Day/ Year) |
4. Trans- |
5. Number of Derivative
Securities Acquired (A) or Disposed of (D) |
6. Date Exercisable |
7. Title and Amount
of Underlying Securities |
8. Price of Derivative
Security |
9. Number of |
10. Owner- |
11. Nature of Indirect
Beneficial Ownership |
||||
Code |
V |
(A) |
(D) |
Date Exer-cisable |
Expira- |
Title |
Amount or Number
of |
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Employee Stock Option (right to buy) | $17.72 |
03/07/03(1) |
|
A |
|
9,719 |
|
01/01/03(1) |
01/01/13 |
Common Stock |
9,719 |
|
9,719 |
D |
|
Explanation of Responses: (1) Under the LabOne, Inc. 2001 Long Term Incentive Plan, Mr. Grant, as an executive officer of LabOne, Inc., became entitled to receive a stock bonus retroactive to January 1, 2003. On February 27, 2003, the board of directors of LabOne approved these bonuses which were contingent on LabOne determining that the executive had met all conditions to such bonus. This determination was finalized on March 7, 2003. |
By: /s/ W. Thomas Grant, II. By Randy Shelton attorney-in-fact Randy Shelton **Signature of Reporting Person |
March 11, 2003 Date |
**Intentional misstatements
or omissions of facts constitute Federal Criminal Violations. Note: File three
copies of this Form, one of which must be manually signed. 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 Number.
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