UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
FORM 4
[ ] Check this box if no longer OMB APROVAL
subject to Section 16. Form 4 or OMB NUMBER: 3235-0287
Form 5 obligations may continue. Expires: September 30, 1998
See Instruction 1(b). Estimated average burden
hours per response........0.5
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
(Print or Type Responses)
1. Name and Address of Reporting Person*
Husain (1) M. Fazle
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(Last) (First) (Middle)
1221 Avenue of the Americas
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(Street)
New York NY 10020
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(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Allscripts, Inc. (MDRX)
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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
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
X Director 10% Owner
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Officer (give title below) Other (specify below)
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7. Individual or Joint/Group Filing (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>
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired 5. Amount of Securities 6. Ownership 7. Nature of
(Instr. 3) action action (A) or Disposed of Beneficially Owned Form: Direct Indirect
Date Code (D) (Instr. 3, 4 at End of Month (D) or In- Beneficial
(Instr.8) and 5) (Instr. 3 and 4) direct (I) Ownership
(Month/ (Instr. 4) (Instr. 4)
Day/ (A) or
Year) Code V Amount (D) Price
- ------------------------- --------- ---- --- ------- --- --------- -------------------- -------------- -------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
4(b)(v).
(Over)
SEC 1474 (7-96)
<PAGE>
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
1. Title of 2. Conversion or 3. Transaction Date 4. Transaction 5. Number of 6. Date Exercisable and
Derivative Exercise Price (Month/Day/Year) Code Derivative Expiration Date
Security of Derivative (Instr. 8) Securities (Month/Day/Year)
(Instr. 3) Security Acquired (A)
or Disposed of
(D) (Instr. 3,
4 and 5)
Date Expiration
Code V (A) (D) Exercisable Date
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
1. Title of 7. Title and Amount of 8. Price of 9. Number of 10. Ownership 11. Nature of
Derivative Underlying Securities Derivative derivative Form of Indirect
Security (Instr. 3 and 4) Security Securities Derivative Beneficial
(Instr. 3) (Instr. 5) Beneficially Security: Ownership
Amount Owned at End Direct (D) (Instr. 4)
or of Month or Indirect
Number (Instr. 4) (I)
of (Instr. 4)
Title Shares
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<S> <C> <C> <C> <C> <C> <C>
</TABLE>
Explanation of Responses:
(1) The Reporting Person is a managing member of Morgan Stanley Venture
Partners III, L.L.C. ("MSVP") which is the General Partner of each of
Morgan Stanley Venture Partners III, L.P., Morgan Stanley Venture
Investors III, L.P. and The Morgan Stanley Venture Partners
Entrepreneur Fund, L.P. (collectively, the "Funds"). Upon
consummation of the transactions described in a Form 4 of Morgan
Stanley Venture Capital III, Inc., which is the institutional
managing member of MSVP, filed the date hereof, the Funds will own
certain of the Issuer's equity securities. The Reporting Person
disclaims any beneficial ownership of any of the Securities owned by
the Funds.
/s/ M. Fazle Husain August 9, 1999
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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 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.
Page 2
SEC 1474 (7-96)
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Joint Filer Information
Each of the following joint filers has designated Morgan Stanley Venture
Capital III, Inc. ("MSVC III, Inc.") as the "Designated Filer" for purposes
of the attached Form 4:
(1) Morgan Stanley Dean Witter & Co. ("MSDW")
1585 Broadway
New York, New York 10036
(2) Morgan Stanley Venture Partners III, L.L.C., ("MSVP III, L.L.C.")
1221 Avenue of the Americas
New York, New York 10020
(3) Morgan Stanley Venture Partners III, L.P. ("MSVP III, L.P.")
1221 Avenue of the Americas
New York, New York 10020
(4) The Morgan Stanley Venture Partners Entrepreneur Fund, L.P.
("Entrepreneur Fund")
1221 Avenue of the Americas
New York, New York 10020
(5) Morgan Stanley Venture Investors III, L.P. ("MSVI")
1221 Avenue of the Americas
New York, New York 10020
Issuer & Ticker Symbol: Allscripts, Inc. (MDRX)
Date of Event Requiring Statement: 7/28/99
Signature:
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By: Stephanie Holmes, as authorized signatory for
MSDW and Assistant Secretary of MSVC III, Inc.,
institutional managing member of MSVP III, L.L.C.,
the General Partner of MSVP III, L.P., the Entrepreneur
Fund, and MSVI
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