FORM 3
U.S. SECURITIES AND EXCHANGE COMMISSION _____________________
WASHINGTON, D.C. 20549 | OMB APPROVAL |
INITIAL STATEMENT OF |_____________________|
BENEFICIAL OWNERSHIP OF SECURITIES |OMB NUMBER: 3235-0104|
|EXPIRES: |
| SEPTEMBER 30, 1998 |
Filed pursuant to Section 16(a) of the |ESTIMATED AVERAGE |
Securities Exchange Act of 1934, |BURDEN HOURS |
Section 17(a) of the Public Utility |PER RESPONSE 0.5 |
Holding Company Act of 1935 |_____________________|
or Section 30(f) of the Investment
Company Act of 1940
1. Name and Address of Reporting Person
Hunziker Charles R.
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(Last) (First) (Middle)
1000 Abernathy Road, Building 400
Suite 1825
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(Street)
Atlanta GA 30328
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
08/28/97
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3. IRS OR SOCIAL SECURITY NUMBER OF REPORTING PERSON (VOLUNTARY)
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4. Issuer Name and Ticker or Trading Symbol
Housecall Medical Resources, Inc. (HSCL)
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5. RELATIONSHIP OF REPORTING PERSON(S) TO ISSUER (CHECK ALL APPLICABLE)
( ) DIRECTOR
( ) 10% OWNER
(XX) OFFICER (GIVE TITLE BELOW)
( ) OTHER (SPECIFY TITLE BELOW)
VP Sales & Marketing
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6. IF AMENDMENT, DATE OF ORIGINAL (MONTH/DAY/YEAR)
N/A
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7. INDIVIDUAL OR JOINT/GROUP FILING (CHECK APPLICABLE LINE)
X FORM FILED BY ONE REPORTING PERSON
FORM FILED BY MORE THAN ONE REPORTING PERSON
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TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security (Instru. 4)
N/A
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2. Amount of Securities Beneficially owned (Instr. 4)
N/A
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3. Ownership Form Direct Direct (E) or Indirect (I) (Instr. 5)
N/A
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4. Nature of Indirect Beneficial Ownership (Instr. 5)
N/A
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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)
Stock Options (Right to Buy)
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2. Date Exercisable and Expiration Date (Month/Day/Year)
(1) (2)
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3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)
Common Stock 20,000
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4. Conversion or Exercise Price of Derivative Security
$4.00
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5. Ownership Form of Derivative Security: Direct(D) or Indirect(I)(Instr. 5)
D
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6. Nature of Indirect Beneficial Ownership (Instr. 5)
N/A
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EXPLANATION OF RESPONSES:
(1) Options vest in 20% increments over 5 years beginning 2/27/98.
(2) Options have ten year expiration date (2/27/08)
/s/ Charles R. Hunziker 9/8/97
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** SIGNATURE OF REPORTING PERSON DATE
_____________________________
** 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 PROVIDED 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.
