U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
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1. Name and Address of Reporting Person*
Commonwealth Associates L.P.
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(Last) (First) (Middle)
830 Third Avenue
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(Street)
New York, New York 10022
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
May 8, 2000
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3. IRS Identification Number of Reporting Person, if an entity (Voluntary)
13-3467952
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4. Issuer Name and Ticker or Trading Symbol
HealthWatch, Inc. (Nasdaq SmallCap Market: HEAL)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
|X| Director |X| 10% Owner
|_| Officer (give title below) |_| Other (specify below)
Robert Priddy is a director
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6. If Amendment, Date of Original (Month/Day/Year)
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7. Individual or Joint/Group Filing (Check applicable line)
|_| Form filed by One Reporting Person
|X| Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5)
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<S> <C> <C> <C>
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</TABLE>
* If the Form is filed by more than one Reporting Person see instruction
5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Page 1 of 5
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FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date ------------------------------ 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
----------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Warrants to purchase Units (1) immed 05/08/05 Common Stock 295,535 (1) D (2)
Series C 8% Convertible Preferred Stock n/a n/a Common Stock 117,333 $1.875 I (3)
Warrants to purchase Common Stock immed 12/23/04 Common Stock 366,668 $0.05 I (3)
Warrants to purchase Common Stock immed 02/07/05 Common Stock 1,000,000 $3.50 I (3)
Series C 8% Convertible Preferred Stock n/a n/a Common Stock 53,333 $1.875 I (4)
Warrants to purchase Common Stock immed 12/23/04 Common Stock 166,667 $0.05 I (4)
Warrants to purchase Units(1) immed 05/08/05 Common Stock 107,680 (1) I (4)
Series D 8% Convertible Preferred Stock n/a n/a Common Stock 57,142 $3.50 I (4)
Warrants to purchase Common Stock immed 05/08/05 Common Stock 14,286 $3.50 I (4)
Series D 8% Convertible Preferred Stock n/a n/a Common Stock 285,714 $3.50 I (5)
Warrants to purchase Common Stock immed 05/08/05 Common Stock 71,430 $3.50 I (5)
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</TABLE>
Explanation of Responses:
See attached footnotes.
Commonwealth Associates L.P.
By: Commonwealth Associates Management Corp., its general partner
/s/ Joseph Wynne 7/3/00
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** Signature of Reporting Person Date
Joseph Wynne
Chief Financial Officer
** 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 provided is insufficient, See Instruction 6 for procedure.
Page 2 of 5
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Page 3
FOOTNOTES
(1) Each Unit consists of (i) 1,000 shares of Series D 8% Convertible Preferred
Stock, each share of which is initially convertible into 28.57 shares of Common
Stock at a conversion price of $3.50, and (ii) warrants to purchase 7,143 shares
of Common Stock at an exercise price of $3.50 per share.
(2) These shares and warrants are owned directly by Commonwealth Associates L.P
("Commonwealth"). Michael S. Falk ("Falk") and Robert Priddy ("Priddy") are
directors and shareholders of Commonwealth Associates Management Corp., the
general partner of Commonwealth ("CAMC"). Falk is the Chairman, CEO and
principal stockholder of CAMC. Falk and Priddy disclaim beneficial ownership of
the shares and warrants held by Commonwealth other than that portion which
corresponds with their respective equity ownership in CAMC.
(3) These shares and warrants are owned directly by ComVest Capital Partners LLC
("ComVest"). Falk and Priddy are Managers and principal members of ComVest. Falk
and Priddy disclaim beneficial ownership of the shares and warrants held by
ComVest other than that portion which corresponds with their respective
membership interests in ComVest.
(4) These shares and warrants are owned directly by Falk.
(5) These shares and warrants are owned directly by Priddy.
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JOINT FILER INFORMATION
Name: Commonwealth Associates Management Corp.
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates L.P.
Issuer & Ticker Symbol: HealthWatch, Inc. (HEAL)
Statement Date: May 8, 2000
Signature: By: /s/ Joseph Wynne
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Joseph Wynne, Chief Financial Officer
Name: Michael S. Falk
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates L.P.
Issuer & Ticker Symbol: HealthWatch, Inc. (HEAL)
Statement Date: May 8, 2000
Signature: /s/ Michael S. Falk
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Michael S. Falk
Name: Keith Rosenbloom
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates L.P.
Issuer & Ticker Symbol: HealthWatch, Inc. (HEAL)
Statement Date: May 8, 2000
Signature: /s/ Keith Rosenbloom
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Keith Rosenbloom
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Name: Robert Priddy
RMC Capital, LLC
1640 Powers Ferry, Suite 125
Marietta, Georgia 30067
Designated Filer: Commonwealth Associates L.P.
Issuer & Ticker Symbol: HealthWatch, Inc. (HEAL)
Statement Date: May 8, 2000
Signature: /s/ Robert Priddy
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Robert Priddy
