FORM 4
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
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OMB APPROVAL |
OMB
Number: 3235-0287 |
1. Name and Address of Reporting Person *
(Last)
(First)
(Middle)
(Street)
(City)
(State) (Zip)
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2. Issuer Name and Ticker Henry Schein, Inc. (HSIC)
3. I.R.S.
Identification |
4. Statement for March 20, 2003
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6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director
10% Owner
X Officer (give title below)
Other (specify below) Vice President - Human Resources and Special Counsel
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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 |
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Code |
V |
Amount |
(A) or (D) |
Price |
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Common Stock |
3/20/03 |
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M |
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563 |
A |
$4.21 |
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Common Stock |
3/20/03 |
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M |
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7,500 |
A |
$16.00 |
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Common Stock |
3/20/03 |
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M |
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4,000 |
A |
$24.56 |
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Common Stock |
3/20/03 |
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S |
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12,063 |
D |
$43.50 |
2,500 |
D |
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(Over)
SEC 1474 (3-99)
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 |
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Code |
V |
(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
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Stock Option |
$4.21 |
3/20/03 |
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M |
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563 |
(1) |
12/31/04 |
Common |
563 |
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-0- |
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Stock Option |
$16.00 |
3/20/03 |
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M |
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7,500 |
(2) |
11/2/05 |
Common |
7,500 |
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-0- |
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Stock Option |
$24.56 |
3/20/03 |
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M |
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4,000 |
(3) |
3/13/07 |
Common |
4,000 |
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5,000 |
D |
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Explanation of Responses: (1) The option vested in three equal installments on December 31, 1995, December 31, 1996 and December 31, 1997. (2) The option vested in three equal installments on November 2, 1996, November 2, 1997 and November 2, 1998. (3) The option vested in three equal installments on March 13, 1998, March 13, 1999 and March 13, 2000. |
/s/ Leonard A. David ** Signature of Reporting Person |
March 21, 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.
http://www.sec.gov/divisions/corpfin/forms/form4.htm
Last update: 09/05/2002