FORM 4 OMB APPROVAL
[ ] Check this box if no longer OMB Number: 3235-0287
subject to Section 16. Form 4 Expires: April 30, 1997
or Form 5 obligations may Estimated average burden
continue. See Instruction 1(b). hours per response - 0.5
U.S. 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(f) of the Investment Company Act of 1940
1. Name and Address of Reporting Person
Stanley M. Bergman
c/o Henry Schein, Inc.
135 Duryea Road
Melville, New York 11747
2. Issuer name and Ticker or Trading Symbol
Henry Schein, Inc./HSIC
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
June 1996
5. If Amendment, Date of Original 4/96
6. Relationship of Reporting Person to Issuer
(Check all applicable)
[x] Director [x] 10% Owner
[x] Officer (give title below) [ ] Other (specify below)
Chairman, Chief Executive Officer and President
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)
Common Stock, $.01 par value per share
Common Stock, $.01 par value per share
2. Transaction Date (Month/Day/Year)
6/4/96
Line purposely left blank
3. Transaction Code (Instr. 8):
Code V
J*
Line purposely left blank
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5):
Amount (A) or (D) Price
27,500 D 0*
Line purposely left blank
5. Amount of Securities Beneficially Owned at End of Month
(Instr. 3 and 4)
164,758.18**
1,274,426.82
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
D
I
7. Nature of Indirect Beneficial Ownership (Instr. 4)
Line purposely left blank
By Trusts***
Reminder: Report on a separate line for each class of securities
beneficially owned directly or indirectly. (Print or Type
Responses)
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. Conversion or Exercise Price of Derivative Security
3. Transaction Date (Month/Day/Year)
4. Transaction Code (Instr. 8):
Code V
5. Number of Derivative Securities Acquired (A) or
Disposed of (D) (Instr. 3, 4, and 5)
(A) (D)
6. Date Exercisable and Expiration Date (Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities (Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security (Instr. 5)
9. Number of Derivative Securities Beneficially Owned at
End of Month (Instr. 4)
10. Onwership Form of Derivative Security: Direct (D) or
Indirect (I) (Instr. 4)
11. Nature of Indirect Beneficial Ownership (Instr. 4)
Explanation of Responses:
* Represents a transfer of 27,500 shares held by Stanley M.
Bergman to a charity.
** Does not include 2,945,660.13 shares held by Stanley M.
Bergman, as voting trustee under voting trust agreements.
Mr. Bergman disclaims beneficial ownership of such shares.
*** Represents shares held by Stanley M. Bergman's wife and
another family member, as co-trustees of trusts for the
benefit of Stanley M. Bergman and members of Mr. Bergman's
family.
** Intentional misstatements or omissions of facts constitute
Federal Criminal Violations. See 18 U.S.C. 1001 and 15
U.S.C. 78ff(a).
/s/Stanley M. Bergman 7/10/96
**Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be
manually signed. If space provided is insufficient, see
Instruction 6 for procedure.
SEC 1474(8-92)