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UNITED STATES OMB APPROVAL
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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OMB Number: 3235-0145
Expires: October 31, 1994
Estimated average burden
hours per response....14.90
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SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 3)*
Oxboro Medical International, Inc.
(Name of Issuer)
Common Stock, Par Value $0.01 Per Share
(Title of Class of Securities)
691384 10 1
(CUSIP Number)
Check the following box if a fee is being paid with this statement |_|. (A fee
is not required only if the filing person: (1) has a previous statement on file
reporting beneficial ownership of more than five percent of the class of
securities described in item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7).
*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).
SEC 1745 (2-95) Page 1 of 4 pages
CUSIP No. 691384 10 1 13G Page 2 of 4 Pages
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1 NAME OF REPORTING PERSON
S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Larry Rasmusson
Social Security # ***-**-****
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) |_|
N/A (b) |_|
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States of America
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5 SOLE VOTING POWER
532,770
NUMBER OF
SHARES ------------------------------------------------
BENEFICIALLY 6 SHARED VOTING POWER
OWNED BY
EACH 6,693 (held in ESOP)
REPORTING ------------------------------------------------
PERSON 7 SOLE DISPOSITIVE POWER
WITH
532,770
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8 SHARED DISPOSITIVE POWER
6,693 (held in ESOP)
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
539,463
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
N/A
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
20.19%
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12 TYPE OF REPORTING PERSON*
Individual (IN)
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* SEE INSTRUCTION BEFORE FILLING OUT!
Page 2 of 4 pages
AMENDMENT NO. 3 TO SCHEDULE 13-G
ITEM 1. NAME AND ADDRESS OF ISSUER:
Oxboro Medical International, Inc.
13828 Lincoln Street N.E.
Ham Lake, Minnesota 55304
ITEM 2. NAME AND ADDRESS OF PERSON FILING:
a. Larry Rasmusson
b. 13828 Lincoln Street N.E.
Ham Lake, Minnesota 55304
c. United States of America
d. Common Stock, Par Value $0.01 Per Share
e. 691384 10 1
ITEM 3. RULE 13-3(b), or 13d-2(b):
Not Applicable
ITEM 4. OWNERSHIP:
a. Amount Beneficially Owned: 539,463
b. Percent of Class: 20.19%
c. Number of Shares as to which such person has:
(i) sole power to vote or direct the vote 532,770
(ii) shared power to vote or to direct the vote 6,693*
(iii) sole power to dispose or to direct the
disposition of 532,770
(iv) shared power to dispose or to direct the
disposition of 6,693*
* held in ESOP
Page 3 of 4 pages
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 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:
By signing below, I certify that to the best of my knowledge and
belief, the securities referred to above were acquired in the ordinary course of
business and were not acquired for the purpose of and do not have the effect of
changing or influencing the control of the issuer of such securities and were
not acquired in connection with or as a participant in any transaction having
such purpose of effect.
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.
February 12, 1997
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Date
/s/ Larry Rasmusson
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Signature
Larry Rasmusson
Page 4 of 4 pages
