SEC Form 4

~~-------------------------- -----------------------------------~~ FORM 4 ~~OMB~~[ ~~APPROVAL~~] ~~-------------------------- ----------------------------------- |_|~~ Check this box if no ~~OMB~~longersubject ~~Number: 3235-0287 longer subject~~ to ~~Expires: January 31,~~ Section 16. Form 4 or ~~2005~~Form5 ~~Form 5~~ obligations may ~~Estimated average burden hours~~ continue. See ~~per response 0.5~~ Instruction 1(b). ~~-----------------------------------~~ 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(fh) of the Investment Company Act of 1940 ~~(Print~~OMB orAPPROVAL ~~Type~~OMB Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to Issuer Reporting Person* (Check all applicable) Stein Jay A. Hologic, Inc. ("Holx") ___X___ Director _______ 10% Owner --------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ___X___ Officer (give _______ Other(specify Number: ~~of Reporting Month/Year title below) below) C/O Hologic Inc. Person (Voluntary) August 2002 Chairman and Chief Technical Officer 35 Crosby Drive~~ 3235-~~-------------------------------~~0287 ------------------------------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Filing (Check ###-##-#### Date of Original Applicable Line) Bedford, MA 01730 (Month/Year) __X__ Form filed by One Reporting Person _____ Form filed by More than One Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action action or Disposed of (D) Securities FormExpires: ~~Indirect~~January ~~Date Code (Instr. 3~~31, 42005Estimated ~~and~~average 5)burdenhours ~~Beneficially~~per ~~Direct (D) or Beneficial (Month/ (Instr~~response.8) ~~Owned at Indirect (I) Ownership Day/ End of Month (Instr~~. ~~4) (Instr~~. ~~4) Year) (Instr~~. 3 ------------------------------------------- and 4) Code V Amount (A) or Price (D) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.01 ~~par value 8/20/02 P - 4,000 A $10~~0.02 280,077 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Over SEC 1474 (7-96) * If the form is filed by more than one reporting person, see Instruction 4(b)(v).5

FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g. puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------------------------------ 1. ~~Title~~Name ofand ~~Derivative~~Address ~~2. Conver- 3. Trans- 4. Transac- 5. Number~~ of 6.Reporting ~~Date~~Person* ~~Exer-~~Stein, 7.Jay ~~Title 8~~A. ~~Price of Security sion of action tion Derivative cisable and Amount Derivative~~ (~~Instr. 3~~Last) ~~Exercise Date Code Securities and of Underlying Security Price of~~ (~~Month/~~First) (~~Instr. Acquired Expiration Securities (Instr. 5~~Middle) ~~Deriv- Day~~c/o 8)Hologic, ~~(A) or Date (Instr~~Inc. 335 ~~and~~Crosby 4)Drive ~~ative Year) Disposed of~~ (~~Month/ Security (D~~Street) ~~(Instr.3~~Bedford, ~~Day/Year)~~MA 401730 ~~and 5) ------------------------------------------------------------------- Code V~~ (ACity) (DState) Date Expi- Amount Exer- ration Title or cisa- Date Number ble of Shares ------------------------------------------------------------------------------------------------------------------------------------ Option* (~~Right to buy~~Zip) $62.~~1875~~ -Issuer -Name -and -Ticker -or ~~1/1~~Trading ~~4/4~~Symbol ~~COMMON 1996 2005 STOCK 8~~Hologic,~~000~~ *Inc.HOLX ~~***~~3. ~~------------------------------------------------------------------------------------------------------------------------------------ Option** (Right to buy) $8~~I.25R.S. -Identification -Number -of -Reporting ~~- 1/1 6/28 COMMON 1996 2005 STOCK 90~~Person,~~000~~ *if ~~------------------------------------------------------------------------------------------------------------------------------------~~an Option**entity (~~Right to buy~~voluntary) ~~$13~~4.~~125~~ -Statement -for ~~- - - 5~~Month/~~5 5~~Day/5Year COMMON 1999 2007 STOCK 15,000 * ------------------------------------------------------------------------------------------------------------------------------------ Option** (Right to buy) $13.125 - - - - - 1209/~~15 12~~17/152002 ~~COMMON~~5. ~~1998~~If ~~2007 STOCK 10~~Amendment,~~000~~ *Date ~~***~~of ~~------------------------------------------------------------------------------------------------------------------------------------~~Original Option** (~~Right to buy~~Month/Day/Year) $6.00 -Relationship -of -Reporting - - 12/8 12/8 COMMON 2000 2009 STOCK 10,000 * *** ------------------------------------------------------------------------------------------------------------------------------------ Option** Person(~~Right~~s) to ~~buy)~~Issuer $6.9375 - - - - - 5/9 11/9 COMMON 2001 2010 STOCK 15,000 * ------------------------------------------------------------------------------------------------------------------------------------ Option** (~~Right~~Check toall ~~buy~~applicable) ~~$5.00~~X -Director ~~- - - - 1/25~~ 10~~/25~~% ~~COMMON~~Owner ~~2001~~X ~~2010~~Officer STOCK 5,000 * *** ------------------------------------------------------------------------------------------------------------------------------------ Option** (~~Right~~give totitle ~~buy~~below) ~~$5.05~~Other - - - - - 10/1 10/1 COMMON 2002 2011 STOCK 1,000 * *** ------------------------------------------------------------------------------------------------------------------------------------ Option** (~~Right~~specify ~~to buy~~below) ~~$10.26~~Description -Chairman -& -Chief -Technical -Officer 11/13 11/13 COMMON 2002 2011 STOCK 50,000 * *** ------------------------------------------------------------------------------------------------------------------------------------ -------------------------------------------------------- 97. ~~Number~~Individual ~~10. Owner- 11. Nature of ship of Indirect Deri- Form of Beneficial vative Deriva- Ownership Secu- tive Security rities (Instr. (Instr.4) Benefi- Direct cially (D)~~ or ~~Owned~~Joint/Group ~~Indirect~~Filing at (I)Check ~~End~~Applicable ~~(Instr.4~~Line) ofX ~~Month~~Form ~~(Instr.4)~~filed ~~--------------------------------------------------------~~by -One DReporting -Person ~~--------------------------------------------------------~~Form -filed Dby -More ~~--------------------------------------------------------~~than -One DReporting - -------------------------------------------------------- - D - -------------------------------------------------------- - D - -------------------------------------------------------- - D - -------------------------------------------------------- - D - -------------------------------------------------------- - D - -------------------------------------------------------- 204,000 D - --------------------------------------------------------Person

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
(Instr. 8)

4. Securities Acquired (A) or Disposed Of (D)
(Instr. 3, 4, and 5)

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)

Code

Amount

A/D

Price

Common Stock, $.01 par value

280,077

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
(Instr.8)

5. Number of Derivative
    Securities Acquired (A)
    or Disposed Of (D)

    (Instr. 3, 4 and 5)

6. Date Exercisable(DE) and
Expiration Date(ED)
(Month/Day/Year)

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
    Transaction(s)
    (Instr.4)

10. Owner-
ship
Form of
Deriv-
ative
Securities:
Direct (D)
or
Indirect (I)

(Instr.4)

11. Nature of
      Indirect
      Beneficial
      Ownership
      (Instr.4)

Code

Title

Amount or Number of Shares

Option*(Right to buy)

$6.1875

1/1/1996***

4/4/2005

COMMON STOCK

8,000

Option**(Right to buy)

$8.25

1/1/1996

6/28/2005

COMMON STOCK

90,000

Option**(Right to buy)

$13.125

5/5/1999

5/5/2007

COMMON STOCK

15,000

Option**(Right to buy)

$13.125

12/15/1998***

12/15/2007

COMMON STOCK

10,000

Option**(Right to buy)

$6.00

12/8/2000***

12/8/2009

COMMON STOCK

10,000

Option**(Right to buy)

$6.9375

5/9/2001

11/9/2010

COMMON STOCK

15,000

Option**(Right to buy)

$5.00

1/25/2001***

10/25/2010

COMMON STOCK

5,000

Option**(Right to buy)

$5.05

10/1/2002***

10/1/2011

COMMON STOCK

1,000

Option**(Right to buy)

$10.26

11/13/2002***

11/13/2011

COMMON STOCK

50,000

Option**(Right to buy)

$9.50

9/17/2002

10,000

9/17/2003***

9/17/2012

COMMON STOCK

10,000

214,000

Explanation of Responses:

*Employee Stock Option granted under the Hologic, Inc. 1986 Combination Stock Option Plan
**Employee Stock Option
***Subject to vesting schedule

By:
/s/ Jay A. Stein 09/19/2002
** Signature of Reporting Person Date

SEC 1474 (8-02)

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).
** 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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