FORM 4
[ ] Check this box if no longer
subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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: 3235-0287
Expires: January 31, 2005
Estimated average burden hours per response. . . . . 0.5 |
1. Name and Address of Reporting Person*
Carroll, Christopher F.
(Last) (First) (Middle)
100 Clearbrook Road
(Street)
Elmsford, NY 10523
(City) (State) (Zip)
|
2. Issuer Name and Ticker or Trading Symbol MIM Corporation MIMS
|
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable) Director
10% Owner
X Officer
Other
Chief Accounting Officer
7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
|
|
3. I.R.S. Identification
Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Day/Year January 27, 2003
5. If Amendment,
Date of Original (Month/Day/Year) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1. Title of Security (Instr. 3) |
2. Transaction Date
(Month/Day/Year) |
2A. Deemed
Execution Date, if any (Month/Day/Year) |
3. Transaction Code and Voluntary Code (Instr. 8) Code | V
|
4. Securities Acquired (A) or Disposed (D) Of (Instr. 3, 4, and 5) Amount | A/D | Price
|
5. Amount of
Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) |
6. Owner-
ship Form: Direct(D) or Indirect (I) (Instr. 4) |
7. Nature of
Indirect Beneficial Ownership (Instr. 4) |
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). |
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. |
(over)
SEC 1474 (9-02) |
Carroll, Christopher F. - January 27, 2003 |
Form 4 (continued) |
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) |
2. Conver-
sion or Exercise Price of Deri- vative Security |
3. Transaction
Date (Month/ Day/ Year) |
3A. Deemed
Execution Date, if any (Month/ Day/ Year) |
4. Transaction
Code and Voluntary (V) Code (Instr.8) Code | V
|
5. Number of Derivative Securities Acquired (A) or Disposed (D) Of (Instr. 3,4 and 5) |
6. Date Exercisable(DE) and
Expiration Date(ED) (Month/Day/Year) (DE) | (ED)
|
7. Title and Amount of
Underlying Securities (Instr. 3 and 4) |
8. Price
of Derivative Security (Instr.5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transactions (Instr.4) |
10. Owner- ship Form of Deriv- ative Security: Direct (D) or Indirect (I) (Instr.4) |
11. Nature of Indirect Beneficial Ownership (Instr.4) |
Employee Stock Option (Right to Buy) |
$5.5600 | 01/27/2003 |
|
A |
|
(A) 50,000 |
01/27/2004 (1) | 01/27/2013
|
Common Stock, $.0001 par value - 50,000 |
|
50,000 |
D
|
|
** 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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. |
/s/ Christopher F. Carroll 03-11-2003 ** Signature of Reporting Person Date Page 2
|
Carroll, Christopher F. - January 27, 2003 |
Form 4 (continued) |
FOOTNOTE Descriptions for MIM Corporation MIMS Form 4 - January 2003 Christopher F. Carroll
100 Clearbrook Road Elmsford, NY 10523 Explanation of responses: (1) Vests and becomes exercisable in three equal annual installments commencing on the first anniversary of the date of grant. |
Page 3 |