FORM 4
[ ] Check this box if no longer subject
to Section 16. Form 4 or Form 5
obligations may continue. See
Instructions 1(b).
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
- -------------------------------------------------------------------------------
1. Name and Address of Reporting Person
Schwartz Sanford L.
- -----------------------------------------------------
(Last) (First) (Middle)
9040 Roswell Road, Suite 470
- -----------------------------------------------------
(Street)
Atlanta, GA 30350
- -----------------------------------------------------
(City) (State) (Zip)
- -------------------------------------------------------------------------------
2. Issuer Name and Ticker or Trading Symbol
HEALTHWATCH, INC. (HEAL)
- -------------------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
----
- -------------------------------------------------------------------------------
4. Statement for Month/Year
10/1999
- -------------------------------------------------------------------------------
5. If Amendment, Date of Original (Month/Year)
- -------------------------------------------------------------------------------
6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] 10% Owner
[X] Director
[ ] Officer (give title below)
[ ] Other (specify below)
- -----------------------------------------------------
7. Individual or Joint/Group Filing (check Applicable Line) [X] Form filed by
One Reporting Person [ ] Form filed by More than One Reporting Person
Page 1
<PAGE>
FORM 4 (continued)
<TABLE>
<CAPTION>
- -------------------------------------------------------------------------------------------------------------------------------
|
TABLE I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|
- -------------------------------------------------------------------------------------------------------------------------------
1. Title of Security |2. Trans- |3. Transac- | 4. Securities Acquired (A) | 5. Amount of | 6. Owner- | 7. Nature of |
| action | tion Code | or Disposed of (D) | Securities | ship Form: | Indirect |
(Instr. 3) | Date | | | Beneficially | Direct (D) | Beneficial |
| | (Instr. 8) | (Instr. 3, 4 and 5) | Owned at End | or Indirect| Ownership |
| (Month/ | | | of Month | (I) | |
| Day/Year) |-------------|--------------------------------| | | |
| | | | Amount | (A) or | Price | (Instr. 3 | (Instr. 4) | (Instr. 4) |
| | Code | V | | (D) | | and 4) | | |
- ----------------------|-----------|------|------|-----------|--------|-----------|---------------|-----------------------------|
<S> | <C> |<C> | <C> |<C> | <C> | <C> | <C> | <C> | <C> |
Common Stock | 09/30/1999|J <F1>| |89,468 | A | 9/16 | 89,468 | I | By CBSI |
- -------------------------------------------------------------------------------------------------------------------------------|
Common Stock | No Change | | | | -- | | 142 | D | -- |
- -------------------------------------------------------------------------------------------------------------------------------|
Common Stock | No Change | | | | -- | | 1,428.4 | I | By CBSI |
- -------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | |
- -------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | |
- -------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | |
- -------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | |
- -------------------------------------------------------------------------------------------------------------------------------|
</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).
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 control number.
SEC 1474 (3-99)
<PAGE>
FORM 4 (continued)
<TABLE>
<CAPTION>
TABLE II--Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g. puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------
1. Title of| 2. Con- | 3. | 4. | 5. Number of| 6. Date Exer- | 7. Title and | 8. Price| 9. Num- | 10. Owner- | 11. |
Derivative| version | Trans- | Trans- | Derivative | cisable and | Amount of Under- | of | ber of | ship Form | Nature|
Security | or Exer-| action | action | Securities | Expiration | lying Securities | Deriv- | Deriva- | of Deriva- | of In-|
| cise | Date | Code | Acquired (A)| Date (Month/ | | ative | tive | tive Secur-| Direct|
(Instr. 3)| Price of| (Month/ | | or Disposed | Day/Year) | (Instr. 3 and 4) | Secur- | Securi- | ity Direct | Bene- |
| Deriva- | Day/ | (Instr.| of (D) | | | ity | ties | (D) or In- | ficial|
| tive | Year) | 8) | |-----------------------------------| | Benefic-| direct (I) | Owner-|
| Security| | | (Instr. 3, | | | | | (Instr. | ially | | ship |
| | | | 4 and 5) | | | | | 5) | Owned at| (Instr. 4) | |
| | |--------|-------------| Date- | Expir-| | Amount or| | End of | |(Instr.|
| | | | | | | Exer- | ation | Title | Number of| | Month | | 4) |
| | |Code| V | (A) | (D) | cisable| Date | | Shares | | (Instr. | | |
| | | | | | | | | | | | 4) | | |
- -----------|---------|---------|----|---|------|------|----------------|-------|----------|---------|---------|--------------------|
<S> |<C> |<C> |<C> |<C>| <C> | <C> | <C> | <C> | <C> | <C> | <C> | <C> | <C> |<C> |
Options |$0.66 | | | | | | Immed. | 08/08 | Common| 35,000 | N/A | 60,000 | D | |
- -----------------------------------------------------------------------------------------------------------------------------------|
Options |$0.66 | | | | | | Immed. | 08/07 | Common| 25,000 | N/A | 60,000 | D | |
- -----------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | | | | | | |
- -----------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | | | | | | |
- -----------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | | | | | | |
- -----------------------------------------------------------------------------------------------------------------------------------|
| | | | | | | | | | | | | | |
- -----------------------------------------------------------------------------------------------------------------------------------|
Explanation of Responses:
<FN>
<F1> Shares were issued in lieu of consulting fees owed. CBSI, LLC is
wholly-owned by Sanford Schwartz.
</FN>
</TABLE>
- ---------------------------
/s/ Sanford L. Schwartz 10/31/99
---------------------------------------- --------------------
** 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).
Page 2
