+--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person Hickman Thomas K - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o OSI Systems, Inc. 12525 Chadron Avenue - -------------------------------------------------------------------------------- (Street) Hawthorne California 90250 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol OSI Systems, Inc. (OSIS) ----------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) 000-00-0000 -------------- 4. Statement for Month/Year November 1997 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [X] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) Managing Director OSI Singapore & OSI Malaysia (Subsidiaries) ---------------------------------------------------------------------------- TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11-5-97 S 3,304 D $13.50 8,737(1) D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ FORM 4 (continued) TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)--CONTINUED
- ----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- Explanation of Responses: (1) Previous filing included 15,187 shares issuable pursuant to fully vested options. These shares will now be reported on Table II only until exercised or canceled. **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. /s/ Thomas Hickman 1/8/98 ------------------------------- ----------------- **Signature of Reporting Person Date
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- Security (Instr. 3) cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of In- Date ative Secur- of De- direct (Month/Day/ Secur- ities rivative Bene- Year) ity Bene- Secu- ficial (Instr. ficially rity: Owner- -------------------------------------------- 5) Owned Direct ship Date Expira- Amount or at End (D) or (Instr. Exer- tion Title Number of of Indi- 4) cisable Date Shares Month rect (1) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------