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+--------+ UNITED STATES
| FORM 5 | SECURITIES AND EXCHANGE COMMISSION
+--------+ Washington, D.C. 20549
[_] Check box if
no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
to Section 16.
Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities
obligations may Exchange Act of 1934, Section 17(a) of the
continue. See Public Utility Holding Company Act of 1935 or
Instruction 1(b). Section 30(f) of the Investment Company Act of 1940
[_] Form 3 Holdings Reported
[_] Form 4 Transactions Reported
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1. Name and Address of Reporting Person*
Perlman, Richard E.
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(Last) (First) (Middle)
c/o InfoCure Corporation, 1765 The Exchange, Suite 500
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(Street)
Atlanta, Georgia 30339
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(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol InfoCure Corporation (INCX)
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3. I.R.S. Identification Number of Reporting Person, if an entity
(Voluntary)
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4. Statement for Month/Year 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)
[X] Director [X] Officer [ ] 10% Owner [ ] Other
(give title below) (specify below)
7. Individual or Joint/Group Reporting (check applicable line)
X Form Filed by One Reporting Person
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Form Filed by More than One Reporting Person
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Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<TABLE>
<CAPTION>
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Month/ (Instr. 8) Owned at the Direct Bene-
Day/ end of (D) or ficial
Year) Issuer's Indirect Owner-
(A) or Fiscal Year (I) ship
Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
* If the form is filed by more than one reporting person, see instruction
4(b)(v).
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Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv-
Security (Instr. 3) sion or action tion Code ative Securities
Exercise Date (Instr. 8) Acquired (A) or
Price of (Month/ Disposed of (D)
Deriv- Day/ (Instr. 3, 4, and 5)
ative Year)
Security
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(A) (D)
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<S> <C> <C> <C> <C> <C>
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Common Stock (Right to Buy) $16.38(1) 1/1/99 A 100(1)
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Common Stock (Right to Buy) $17.50(1) 6/9/99 A 440,000(1)
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</TABLE>
<TABLE>
<CAPTION>
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6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na-
cisable and Underlying Securities of of Deriv- ship ture
Expiration (Instr. 3 and 4) Deriv- ative of De- of In-
Date ative Secur- rivative direct
(Month/Day/ Secur- ities Secu- Bene-
Year) ity Bene- rity: ficial
(Instr. 5) ficially Direct Owner-
-------------------------------------------- Owned (D) or ship
Date Expira- Amount or at End Indi- (Instr. 4)
Exer- tion Title Number of of Year rect (1)
cisable Date Shares (Instr. 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
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1/1/03 1/1/09 Common 100(1) 100(1) D
Stock
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(2) 6/9 /09 Common 440,000(1) 440,000(1) D
Stock
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</TABLE>
Explanation of Responses:
(1) Reflects a 2-for-1 stock split in the form of a stock dividend on 8/19/99.
(2) On 6/9/00, exercisable as to 110,000 shares; on 6/9/01, exercisable as to
220,000 shares; on 6/9/02, exercisable as to 330,000 shares; on 6/9/03,
exercisable as to 440,000 shares.
/s/ Richard O. Perlman February 16, 2000
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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.
