UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
ANNUAL 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
[_] CHECK THIS BOX IF NO LONGER SUBJECT TO SECTION 16. FORM 4 OR FORM 5
OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(B).
[_] FORM 3 HOLDINGS REPORTED
[_] FORM 4 TRANSACTIONS REPORTED
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OMB APPROVAL
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OMB Number 3235-0362
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Estimated average burden
hours per response.......... 0.5
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(Print or Type Responses)
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1. Name and Address of Reporting Person*
GILL DAVID N.
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(Last) (First) (Middle)
2712 Long Grove Dr.
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(Street)
Marietta Georgia 30062
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(City) (State) (Zip)
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2. Issuer Name AND Ticker or Trading Symbol
Novoste Corporation (NOVT)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
DECEMBER 1999
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[_] Director [_] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
Chief Financial Officer
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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 ACQUIRED, DISPOSED OF,
OR BENEFICIALLY OWNED
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<TABLE>
<CAPTION>
5. 6.
3. 4. Amount of Owner-
Transaction Securities Acquired (A) or Securities ship
Code Disposed of (D) Beneficially Form: 7.
(Instr. 8) (Instr. 3, 4 and 5) Owned at Direct Nature of
2. ---------- ----------------------------- End of (D) or Indirect
1. Transaction (A) Month Indirect Beneficial
Title of Security Date Code V Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
NY:54634.1
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FORM 5 (CONTINUED)
TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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<TABLE>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- Form of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- Securities Date Securities Price Bene- ity: In-
cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Stock Option $11.00 10/27/99 A 10,000 10/27/00* Common $10,000 10,000 D
(Right to Buy) Stock
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</TABLE>
Explanation of Responses:
*Option vests 1/4 on 10/27/00, 1/4 on 10/27/01, 1/4 on 10/27/02,
and 1/4 on 10/27/03.
/s/ David N. Gill February 14, 2000
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DAVID N. GILL 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 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 Member.
NY:54634.1 SEC 2270 (9-96)
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