FORM 4 o Check this box if no longer subject to Section
16. Form 4 or Form 5 obligations may
continue. |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
|
OMB APPROVAL |
OMB
Number: 3235-0287 |
1. Name and Address of Reporting Person *
(Last)
(First)
(Middle)
135 Duryea Rd. (Street)
(City)
(State) (Zip)
|
2. Issuer Name and
Ticker Henry Schein, Inc. (HSIC) 3. I.R.S.
Identification |
4. Statement for February 25, 2003
|
(Check
all applicable) X Director
Officer (give title below)
10% Owner
Other (specify below)
|
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security |
2. Transaction Date
(Month/Day/ |
2A. Deemed Execution Date,
if any (Month/Day/ |
3. Transaction Code |
4. Securities Acquired (A)
or Disposed of (D) |
5. Amount of Securities
Beneficially Owned Following Reported Transaction(s) |
6. Ownership Form: Direct
(D) or Indirect (I) |
7. Nature of Indirect
Beneficial Ownership |
|||
Code |
V |
Amount |
(A) or (D) |
Price |
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Table II Derivative Securities Acquired, Disposed of, or
Beneficially Owned |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date |
3A. Deemed Execution Date,
if any (Month/Day/ |
4. Transaction Code (Instr. 8) |
5. Number of Derivative
Securities Acquired (A) or Disposed of (D) |
6. Date Exercisable and
Expiration Date |
7. Title and Amount of
Underlying Securities |
8. Price of Derivative
Security |
9. Number of Derivative
Securities Beneficially Owned Following Reported Transaction(s) |
10. Ownership Form of
Derivative Securities: Direct (D) or Indirect (I) |
11. Nature of Indirect
Beneficial Ownership |
||||
Code |
V |
(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
||||||||
Stock Option (Right to buy) (1) |
$38.84 |
2/25/03 |
|
A |
|
7,500 |
|
(2) |
2/25/13 |
Common Stock |
7,500 |
|
7,500 |
D |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Explanation of Responses: (1) Acquired pursuant to the Issuers 1996 Non-Employee Director Stock Option Plan. (2) Pursuant to the terms of the stock option agreement between the Issuer and the Reporting Person, the option becomes exercisable in three (3) equal annual installments beginning on the first (1st) anniversary of the grant date specified in Column 3.
|
/s/ Philip A. Laskawy ** Signature of Reporting Person |
February 26, 2003 Date |
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).
** 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 is insufficient, see Instruction 6 for procedure.