Prepared by R.R. Donnelley Financial -- Form 5

 
Form 5
 

[_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[_] Form 3 Holdings Reported
[_] Form 4 Transactions Reported
 
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
 
ANNUAL 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
 
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1.   Name and Address of Reporting Person*
 
Hickman Thomas K

 
2.   Issuer Name and Ticker or Trading Symbol
 
OSI Systems, Inc (OSIS)
 
6.   Relationship of Reporting Person(s) to Issuer
(Check all applicable)
 
_  Director     _ 10% Owner
x  Officer (give title below)
_  Other (specify below)
 
Managing Director
                                                                            



   
(Last)            (First)        (Middle)
 
3.   I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
 
4.   Statement for Month/Year
 
C/O OSI Systems, Inc
12525 Chadron Ave
     
6/02
 

   



(Street)
 
 
 
Hawthorne CA 90250

(City)            (State)            (Zip)
     
5.   If Amendment, Date of Original (Month/Year)
 
 
7.   Individual or Joint/Group Reporting
(CheckApplicable Line)
x  Form Filed by One Reporting Person
_  Form Filed by More than One Reporting Person







Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

















1.   Title of Security
(Instr. 3)
 
2.   Transaction Date
(Month/Day/Year)
 
3.   Transaction Code
(Instr. 8)
 
4.   Securities Acquired (A) or Disposed of (D)
( Instr. 3, 4 and 5)
 
5.   Amount of Securities Beneficially Owned at the end of Issuer’s Fiscal Year (Instr. 3 and 4)
 
6.   Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
 
7.   Nature of
Indirect
Beneficial Ownership (Instr. 4)
         

           
           
Amount
 
(A) or (D)
 
Price
     
                           

















Common Stock
 
5/22/02
 
M
 
6147
 
A
 
11.50
           

















                                 

















Common Stock
 
5/22/02
 
S
 
3350
 
D
 
21.33
 
17,797
 
D
   

















                                 

















                                 

















                                 

















*
 
If the form is filed by more than one reporting person, see instruction 4(b)(v).



Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1.   Title of Derivative Security
(Instr. 3)  
 
2.   Conversion
or Exercise Price of Derivative Security
 
3.   Transaction Date
(Month/Day/Year)
 
4.   Transaction Code
(Instr. 8)
 
5.   Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
 
6.   Date Exercisable and Expiration Date (Month/Day/Year)
 
7.   Title and Amount of Underlying Securities (Instr. 3
and 4)
 
8.   Price of
Derivative Security
(Instr. 5)
 
9.   Number of Derivative Securities Beneficially Owned at
End of Year (Instr. 4)
 
10.   Ownership of Derivative Security:
Direct (D) or Indirect (I) (Instr. 4)
 
11.   Nature
of Indirect Beneficial Ownership (Instr. 4)
             











               
               
    (A)    
 
    (D)    
 
Date
Exercisable
 
Expiration Date
 
    Title    
 
Amount or Number of Shares
               



























Options to Purchase
 
19.95
 
1/29/02
 
A
 
1500
     
1
 
1/29/07
 
Common Stock
 
1500
 
19.95
     
D
   



























Common Stock
                                                   



























Options to Purchase
 
11.50
 
5/31/97
 
J
     
228
 
2
 
5/31/97
 
Common Stock
 
228
 
11.50
           



























Common stock
                                                   



























Options to Purchase
 
11.50
 
5/22/02
 
M
     
6147
 
3
 
5/31/97
 
Common Stock
 
6147
 
11.50
 
22650
       



























Common Stock
                                                   



























                                                     



























                                                     



























                                                     



























                                                     



























Explanation of Responses:   1) VESTED OVER A PERIOD OF THREE YEARS FROM THE GRANT DATE
2) EXPIRED 228 OPTIONS TO PURCHASE COMMON STOCK ON 5/31/02
3) ENTIRE STOCK OPTIONS ARE VESTED
 
 
 
 
 
/sd/
                                                                                                                                                                               
    
8/10/02
                                                                                                                                                                               
**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).
 
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