| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL 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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1. Name and Address of Reporting Person*
Carroll, Christopher
F.
(Last) (First) (Middle)
100 Clearbrook Road
(Street)
Elmsford, NY 10523
(City) (State) (Zip)
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2. Date of Event
Requiring Statement
(Month/Day/Year)
January 03, 2003
3. I.R.S. Identification
Number of Reporting
Person, if an entity
(voluntary)
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4. Issuer Name and Ticker or Trading Symbol
MIM Corporation MIMS
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable) Director
10% Owner
X Officer
Other
Officer/Other
Description
Chief Accounting Officer
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6. If Amendment, Date of
Original (Month/Day/Year)
7. Individual or Joint/Group
Filing (Check Applicable Line) X Individual Filing
Joint/Group Filing
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Table I - Non-Derivative Securities Beneficially Owned
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1. Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form :
(D) Direct
(I) Indirect (Instr. 5) |
4. Nature of Beneficial Ownership
(Instr. 5)
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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 5(b)(v).
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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 1473 (7-02) |
| Carroll, Christopher F. - January 03, 2003 |
| Form 3 (continued) |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security
(Instr. 4)
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2. Date Exercisable(DE) and Expiration Date(ED)
(DE) | (ED)
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3. Title and Amount of of Underlying Security
(Instr. 4)
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4. Conversion or
Exercise Price
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5. Ownership
Form
(D) Direct
or
(I) Indirect
(Instr. 5)
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6. Nature of Indirect
Beneficial Ownership
(Instr. 5)
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** 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.
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/s/ Christopher F. Carroll
________________________________ 03-11-2003 ** Signature of Reporting Person Date
Page 2
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