UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
( ) Check this box if no longer subject to Section 16
Form 4 or Form 5 obligations may continue. See Instructions 1(b)
1. Name and Address of Reporting Person
Jacquelyn J. Magno
C/O ACADIA NATIONAL HEALTH SYSTEMS, INC.
460 MAIN STREET
LEWISTON, MAINE 04240
US
2. Issuer Name and Ticker or Trading Symbol
ACADIA NATIONAL HEALTH SYSTEMS, INC.
ACAD
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
SEPTEMBER, 1997
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable
(X) Director (X) 10% Owner (X) Officer (give title below) (X) Other
(specify below)
Vice President and
Secretary of the Board of Directors
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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1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of | |7.Nature of Indirect
| Transaction | or Disposed of (D) | Securities |6.Dir | Beneficial Ownership
| | | | Beneficially |ect |
| | | | | | | Owned at End |(D)or |
| | | | | A/| | of Issuer's |Indir |
| Date |Code|V| Amount | D | Price | Fiscal Year |ect(I)|
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<S> <C> <C> <C><C> <C> <C> <C> <C> <C>
COMMON STOCK (voting) | | | |710,360 (19.02%) |D | |0 |D |
| | | | | | | | |
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Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned
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1.Title of Derivative |2.Con- |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of
Security |version |Transaction | rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect
|or Exer | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial
|cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership
|Price of| | | posed of(D) |Day/Year) | |rity |Benefi |or |
|Deriva- | | | |Date |Expir| | |ficially |Ind|
|tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire|
|Secu- | | | | | D |cisa-|Date | of Shares | |End of |ct |
|rity |Date |Code|V| Amount | |ble | | | |Year |(I)|
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<S> <C> <C> <C> <C><C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Explanation of Responses
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete
and correct.
/s/ Mark T. Thatcher
MARK T. THATCHER, Filing Agent
Acadia National Health Systems, Inc.
DATED
NOVEMBER 10, 1997
