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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. __)*
MICRO THERAPEUTICS, INC.
(Name of Issuer)
Common Stock
(Title of Class of Securities)
59500W100
(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).
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SCHEDULE 13G
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CUSIP NO. 59500W100 PAGE 2 OF 4 PAGES
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1 NAME OF REPORTING PERSONS/
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
George B. Wallace
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(SEE INSTRUCTIONS)
(a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4
CITIZENSHIP OR PLACE OF ORGANIZATION
United States
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5
NUMBER OF SOLE VOTING POWER
SHARES 343,888
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6
REPORTING SHARED VOTING POWER
BENEFICIALLY 0
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7
OWNED BY SOLE DISPOSITIVE POWER
EACH 343,888
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8
PERSON SHARED DISPOSITIVE POWER
WITH 0
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9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
343,888
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10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES [ ]
(See Instructions)
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11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
5.08%
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12
TYPE OF REPORTING PERSON (See Instructions)
IN
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ITEM 1.
(a) Name of Issuer: Micro Therapeutics, Inc.
(b) Address of Issuer's Principal Executive Offices:
2 Goodyear
Irvine, California 92618
ITEM 2.
(a) Name of Person Filing: George B. Wallace
(b) Address of Principal Business Office:
2 Goodyear, Irvine, California 92618
(c) Citizenship: United States of America
(d) Title of Class of Securities: Common Stock
(e) CUSIP Number: 59500W100
ITEM 3.
If this statement is filed pursuant Rule 13d-1(b), or 13d-2(b), check
whether the person filing is a:
(a) [ ] Broker or dealer registered under Section 15 of the Act;
(b) [ ] Bank as defined in Section 3(a)(6) of the Act;
(c) [ ] Insurance Company as defined in Section 3(a)(19) of the Act;
(d) [ ] Investment Company registered under Section 8 of the
Investment Company Act;
(e) [ ] Investment Advisor registered under Section 203 of the
Investment Advisors Act of 1940;
(f) [ ] Employee Benefit Plan, Pension Fund which is subject
to the provisions of the Employee Retirement Income
Security Act of 1974 or Endowment Fund; see Rule
13d-1(b)(1)(ii)(F)
(g) [ ] Parent Holding Company, in accordance with Rule 13d-1(b)(ii)(G)
(Note, See Item 7);
(h) [ ] Group, in accordance with Rule 13d-1(b)(1)(ii)(H).
ITEM 4. OWNERSHIP.
If the percent of the class owned, as of December 31, 1998, or as of the
last day of any month described in Rule 13d-1(b)(2), if applicable, exceeds five
percent, provide the following information as of that date and identify those
shares which there is a right to acquire.
(a) Amount beneficially owned: 343,888 shares of Common Stock;
includes 55,315 shares subject to options exercisable within
60 days of December 31, 1998.
(b) Percent of Class: 5.08%
(c) Number of shares as to such person has:
(i) sole power to vote or to direct the vote of 343,888;
(ii) shared power to vote or to direct the vote of 0;
(iii) sole power to dispose or to direct the disposition of
343,888;
(iv) shared power to dispose or to direct the disposition of 0.
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ITEM 5. OWNERSHIP OF 5% OR LESS OF CLASS.
If this statement is being filed to report the fact that as of the
date hereof the reported person has ceased to be the beneficial owner of more
than 5% of the class of securities, check the following: |_|
ITEM 6. OWNERSHIP OF MORE THAN 5% ON BEHALF OF ANOTHER PERSON
Not applicable.
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE
SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY.
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.
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.
Date: February 16, 1999 By: /s/ George B. Wallace
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George B. Wallace, President and Chief
Executive Officer
