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 |
OMB APPROVAL OMB Number: 3235-0362 Expires: January 31, 2005 Estimated average burden hours per response...1.0 |
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 | ||||||
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 Issuers
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). |
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 |
||||||||||||||||||||||||||
/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). |
Note: |
File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure.
|