SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS
FILED PURSUANT TO RULES 13d-1(b) AND (c)
AND AMENDMENTS THERETO FILED
PURSUANT TO 13d-2(b)
(Amendment No. )*
HealthCore Medical Solutions, Inc.
(Name of Issuer)
Class A Common Stock, par value $.01
(Title of Class of Securities)
42220B101
(CUSIP Number)
* The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
(Continued on following page(s))
Page 1 of 5 Pages
<PAGE>
CUSIP No. 42220B101 13G Page 2 of 5 Pages
- --------------------------------------------------------------------------------
1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Neal J. Polan
###-##-####
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
(b) |_|
- --------------------------------------------------------------------------------
3 SEC USE ONLY
- --------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
- --------------------------------------------------------------------------------
NUMBER OF 5 SOLE VOTING POWER
SHARES 502,000
------------------------------------------------------------
BENEFICIALLY 6 SHARED VOTING POWER
OWNED BY 0
------------------------------------------------------------
EACH 7 SOLE DISPOSITIVE POWER
REPORTING 358,000
------------------------------------------------------------
PERSON 8 SHARED DISPOSITIVE POWER
WITH 0
- --------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
502,000*
- --------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
|X|
- --------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
14.9
- --------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
IN
- --------------------------------------------------------------------------------
SEC 174__ (6-__) * SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
Page 3 of 5 Pages
Item 1(a). Name of Issuer :
HealthCore Medical Solutions, Inc.
Item 1(b). Address of Issuer's Principal Executive Offices:
11904 Blue Ridge Boulevard
Grandview, Missouri 64030
Item 2(a). Name of Person Filing:
Neal J. Polan
Item 2(b). Address of Principal Business Office or if none, Residence:
1325 Avenue of the Americas
Suite 1200
New York, New York 10019
Item 2(c). Citizenship:
United States
Item 2(d). Title of Class of Securities:
Class A Common Stock, par value $.01
Item 2(e). CUSIP Number:
42220B101
Item 3. Not Applicable
Item 4. Ownership:
(a) Amount Beneficially Owned: 502,000 shares
Includes (i) 142,000 shares of Class A Common Stock issuable upon
exercise of outstanding warrants and (ii) 144,000 shares of Class
A Common Stock which Mr. Polan has the power to vote pursuant to
a voting proxy. Excludes 167,000 shares of Class A Common Stock
issuable upon exercise of outstanding warrants which, as of
December 31, 1997, were not exercisable within 60 days. Of the
shares of Common Stock held by Mr. Polan, 216,000 of the shares
are shares of Class B Common Stock which are entitled to five
votes per share and are convertible into shares of Class A Common
Stock under certain circumstances.
<PAGE>
Page 4 of 5 Pages
(b) Percent of Class: 14.9
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote: 502,000
(ii) shared power to vote or to direct the vote: 0
(iii) sole power to dispose or to direct the disposition of: 358,000
(iv) shared power to dispose or to direct the disposition of: 0
Item 5. Ownership of Five Percent or Less of a Class
Not Applicable
Item 6. Ownership of More than Five Percent on Behalf of Another Person
Not Applicable
Item 7. Identification and Classification of Subsidiary Which Acquired the
Securities
Not Applicable
Item 8. Identification and Classification of Members of the Group
Not Applicable
Item 9. Notice of Dissolution of Group
Not Applicable
Item 10. Certification
Not Applicable
<PAGE>
Page 5 of 5 Pages
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.
February 6, 1998
By: /s/ Neal J. Polan
--------------------------
Neal J. Polan
