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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b). (Print or Type Responses)
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1. Name and Address of Reporting Person*
Laskawy Philip A.
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(Last) (First) (Middle)
c/o Henry Schein, Inc.
135 Duryea Road
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(Street)
Melville New York 11747
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Henry Schein, Inc. (HSIC)
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3. IRS Social Security Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Year
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5. If Amendment, Date of Original (Month/Year)
June 10 2002
See explanation of responses.
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director 10% [_] Owner
[_] Officer (give title below) [_] Other (specify below)
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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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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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4. 5. 6.
Securities Acquired (A) Amount of Owner-
3. or Disposed of (D) Securities ship
Trans- (Instr. 3, 4 and 5) Benefi- Form: 7.
2. action ----------------------- cially Direct Nature of
1. Transaction Code Owned at End (D) or Indirect
Title of Security Date (Instr. 8) (A) of Month Indirect Beneficial
(Instr. 3) (Month/ ---------- or (Instr. 3 (I) Ownership
Day/Year) Code V Amount (D) Price and 4) (Instr.4) (Instr. 4)
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Common Stock, par value 05/28/2002 P 1,100 A $49.79 I By Spouse
$0.01 per share
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Common Stock, par value 05/28/2002 P 200 A $49.77 I By Spouse
$0.01 per share
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Common Stock, par value 05/28/2002 P 500 A $49.76 I By Spouse
$0.01 per share
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Common Stock, par value 05/28/2002 P 100 A $49.758 I By Spouse
$0.01 per share
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Common Stock, par value 05/28/2002 P 100 A $49.759 2,000 I By Spouse
$0.01 per share
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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)
Please see reverse explanation of footnotes.
(Over)
SEC 1474 (7-96)
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FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Employee Stock $40.82 03/05/02 A V 10,000 (2) 03/05/12 Common 10,000 10,000 D
Option (1)
(right to buy)
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Explanation of Responses:
This amendment is to correct errors in columns 3 and 4 of Table I of the
original filing.
(1) Granted pursuant to the Henry Schein, Inc. 2001 Non-employee Director
Stock Option Plan.
(2) The option becomes exercisable in three equal annual
installments beginning March 5, 2003.
/s/ Philip A. Laskawy 1/6/03
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**Signature of Reporting Person Date
**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.
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SEC 1474 (7-96)
