| Form 5/A ¨ 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(h) 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* | |||||
| Good
Steven
| ||||||
| | ||||||
| (Last)
(First)
(Middle) | ||||||
| c/o OSI Systems, Inc. 12525 Chadron
Ave. | ||||||
| | ||||||
|
(Street) | ||||||
| Hawthorne
CA
90250 | ||||||
| | ||||||
| (City)
(State)
(Zip) | ||||||
| 2. |
Issuer Name and Ticker or Trading Symbol | |||||
| OSI Systems, Inc. (OSIS) | ||||||
| 3. |
I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) | |||||
| 4. |
Statement for Month/Year | |||||
| 6/02 | ||||||
| 5. |
If Amendment, Date of Original (Month/Year) | |||||
| 6. |
Relationship of Reporting Person(s) to Issuer (Check all applicable) | |||||
| x Director ¨ 10% Owner ¨ Officer (give title below) ¨ Other (specify below) | ||||||
| 7. |
Individual or Joint/Group Reporting (Check applicable 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) | |||||
| Common Stock | ||||||
| 2. |
Transaction Date (Month/Day/Year) | |||||
| 3/14/02 | ||||||
| 3. |
Transaction Code (Instr. 8) | |||||
| S | ||||||
| 4. |
Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | |||||
| Amount
(A) or (D) |
Price | |||||
| 5,000
D |
26.00 | |||||
| 5. |
Amount of Securities Beneficially Owned at the end of Issuer’s Fiscal Year (Instr. 3 and
4) | |||||
| 5,000 |
||||||
| 6. |
Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | |||||
| I |
||||||
| 7. |
Nature of Indirect Beneficial Ownership (Instr. 4) | |||||
| , |
Good, Swartz, Brown & Berns Pension Sharing Plan |
|||||
* 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) | |||||
| Options to Purchase Common Stock | ||||||
| 2. |
Conversion or Exercise Price of Derivative Security | |||||
| 19.95 | ||||||
| 3. |
Transaction Date (Month/Day/Year) | |||||
| 1/29/02 | ||||||
| 4. |
Transaction Code (Instr. 8) | |||||
| A |
||||||
| 5. |
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | |||||
| (A) 10,000 |
(D) | |||||
| 6. |
Date Exercisable and Expiration Date (Month/Day/Year) | |||||
| Date Exercisable * |
Expiration Date 1/29/07 | |||||
| 7. |
Title and Amount of Underlying Securities (Instr. 3 and 4) | |||||
| Title Common Stock |
Amount or Number of Shares 10,000 | |||||
| 8. |
Price of Derivative Security (Instr. 5) | |||||
| 19.95 |
||||||
| 9. |
Number of Derivative Securities Beneficially Owned at End of Year (Instr. 4) | |||||
| 27,500 |
||||||
| 10. |
Ownership of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | |||||
| D |
||||||
| 11. |
Nature of Indirect Beneficial Ownership (Instr. 4) | |||||
Explanation of Responses:
* Vested over three year period from the grant date.
| /s/ Steven Good |
8/27/02 | |
| **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.
|
Last update: 07/30/2002