FORM 4
Check this box if no longer (Print or Type Responses) |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION 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
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OMB APPROVAL |
1. Name and Address of Reporting Person* Dean, Norman M. |
2. Issuer Name and Tickler or Trading Symbol ALARIS Medical, Inc. ("AMI") |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
X
Director
10% Owner
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(Last) (First) (Middle) c/o ALARIS Medical Systems, Inc. 10221 Wateridge Circle |
3. I.R.S. Identification |
4. Statement for Month/Day/Year 4/14/2003 |
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(Street)
San Diego, CA 92121
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5. If Amendment, Date of |
7. Individual or Joint/Group Filing (Check Applicable Line)
X
Form filed by One Reporting Person |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date |
2A. Deemed Execution Date, if any (Month/Day/Year) |
3. Transaction Code |
4. Securities Acquired (A) |
5. Amount of Securities |
6. Ownership |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code |
V |
Amount |
(A) or (D) |
Price |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of |
2.Conversion or |
3.Transaction Date |
3A. Deemed Execution Date, if any (Month/Day/Year) |
4.Transaction Code |
5.Number of Derivative |
6.Date Exerciseable |
7.Title and Amount of |
8.Price of |
9.Number of |
10.Ownership |
11.Nature of |
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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AMI Stock Option Grant
Right to Buy |
$10.595 |
4/14/2003 | A |
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2,359 |
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4/14/2003 | 4/14/2013 | AMI Common Stock | 2,359 | $10.595 | 85,152 | D |
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Explanation of Responses: |
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/s/ WILLIAM C. BOPP WILLIAM C. BOPP, SENIOR VICE PRESIDENT & CHIEF FINANCIAL OFFICER
AS ATTORNEY-IN-FACT FOR NORMAN M. DEAN |
APRIL
14, 2003 |
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Reminder: |
Report on a separate line for each class of securities beneficially owned directly or indirectly. |
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* |
If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
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** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations |
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Note: |
File three copies of this Form, on of which must be manually signed. If space is insufficient, see Instruction 6 for procedure |