FORM 4
Check this box if no longer (Print or Type Responses) |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION 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
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OMB APPROVAL |
1. Name and Address of Reporting Person* Brown, Hank |
2. Issuer Name and Tickler or Trading Symbol ALARIS Medical, Inc. ("AMI") |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
x Director
10% Owner
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(Last) (First) (Middle) c/o ALARIS Medical Systems, Inc. 10221 Wateridge Circle |
3. I.R.S. Identification |
4. Statement for Month//Day/Year March 24, 2003 |
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(Street) San Diego, CA 92121 |
5. If Amendment, Date of |
7. Individual or Joint/Group Filing (Check Applicable Line)
x
Form filed by One Reporting Person |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date |
2A. Deemed Execution Date, if any (Month/Day/Year) |
3. Transaction Code |
4. Securities Acquired (A) |
5. Amount of Securities |
6. Ownership |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code |
V |
Amount |
(A) or (D) |
Price |
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AMI Common Stock | 3/24/2003 | M | 6,666 | A | $1.25 | 11,666 | D | |||
AMI Common Stock | 3/24/2003 | M | 3,333 | A | $1.75 | 14,999 | D | |||
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of |
2.Conversion or |
3.Transaction Date |
3A. Deemed Execution Date, if any (Month/Day/Year) |
4.Transaction Code |
5.Number of Derivative |
6.Date Exerciseable |
7.Title and Amount of |
8.Price of |
9.Number of |
10.Ownership |
11.Nature of |
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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AMI Stock Option Exercise | $1.25 | 3/24/2003 | M | 6,666 | (1) | 7/27/2005 | AMI Common Stock | 6,666 | $1.25 | 42,601 | D | ||||
AMI Stock Option Exercise |
$1.75 |
3/24/2003 |
M |
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3,333 |
7/27/2002 |
7/27/2006 |
AMI Common Stock |
3,333 |
$1.75 |
39,268 |
D |
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Explanation of Responses: 3,333 shares became exercisable on 7/27/2002.
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/s/ STUART E. RICKERSON STUART E. RICKERSON VICE PRESIDENT, GENERAL COUNSEL AND SECRETARY, AS ATTORNEY-IN-FACT FOR HANK BROWN
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MARCH
25, 2003 |
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Reminder: |
Report on a separate line for each class of securities beneficially owned directly or indirectly. |
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* |
If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
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** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations |
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Note: |
File three copies of this Form, on of which must be manually signed. If space is insufficient, see Instruction 6 for procedure |