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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
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OMB APPROVAL |
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OMB
Number: 3235-0287 |
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1. Name and Address of Reporting Person *
(Last)
(First)
(Middle)
75 State Street (Street)
(City)
(State) (Zip)
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2. Issuer Name and Ticker Fisher Scientific International, Inc. (FSH)
3. I.R.S.
Identification |
4. Statement for 4/8/03
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6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director
Officer (give title below)
10% Owner
Other (specify below)
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Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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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, par value $.01 per share |
4/8/03 |
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J (1) |
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5,977,006 |
D |
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- 0 - |
I |
See Note (1) |
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Common Stock, par value $.01 per share |
4/8/03 |
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J (1) |
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563 |
A (2) |
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12,769 |
D |
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Table II — Derivative Securities Acquired, Disposed of, or
Beneficially Owned |
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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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Explanation
of Responses: (1) Represents shares of the issuer held directly by Thomas H. Lee Equity Fund III, L.P. (“Equity Fund III”), THL FSI Equity Investors, L.P. (“FSI”) and Thomas H. Lee Foreign Fund III, L.P. (“Foreign Fund III”), which the reporting person may be deemed to beneficially own. On April 8, 2003 Equity Fund III, Foreign Fund III, FSI, and Equity Advisors III issued a pro rata distribution of common stock of the Issuer to their respective general and limited partners. The reporting person disclaims beneficial ownership of such shares, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for the purpose of Section 16 or for any other purpose, except to the extent of its pecuniary interest therein. (2) Represents shares distributed to the reporting person in connection with the distribution described in footnote (1) above.
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/s/ Kent R. Weldon ** Signature of Reporting Person |
April 8, 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