UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Warrant (Right to Buy) | Â (1) | 04/06/2014 | Common Stock | 8,938 (3) | $ 11.19 (3) | D | Â |
Series A Convertible Preferred Stock | Â (1) | Â (2) | Common Stock | 169,794 | $ (2) | D | Â |
Series B Convertible Preferred Stock | Â (1) | Â (2) | Common Stock | 2,035,623 | $ (2) | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BOSTON SCIENTIFIC CORP ONE BOSTON SCIENTIFIC PLACE NATICK, MA 01760 |
 |  X |  | 10% Owner |
/s/ Lawrence J. Knopf, Senior Vice President and Deputy General Counsel | 11/09/2007 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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). |
(1) | Securities are fully exercisable or convertible, as the case may be. |
(2) | These securities are preferred stock of Power Medical Interventions, Inc. and do not have an expiration date. These securities will automatically convert into shares of Power Medical Interventions, Inc.'s common stock upon the consummation of Power Medical Interventions, Inc.'s initial public offering. |
(3) | This Form 3 is being filed to amend the Reporting Person's Form 3, filed on October 25, 2007, solely for the purpose of correcting the presentation of the values in columns 3 and 4 which appeared in reverse order in the original filing. |