U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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
[ ] Check this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person
Reiner Thomas Francis
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(Last) (First) (Middle)
4478 Fleetwood Road
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(Street)
Danville CA 94506
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Sparta Surgical Corporation (SPSG
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3. IRS or Social Security Number of Reporting Person (Voluntary)
###-##-####
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4. Statement for Month/Year
12/00
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ X ] Director [ ] 10% Owner
[ X ] Officer (give title below) [ ] Other (specify below)
Chairman, President and CEO
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<PAGE>
<TABLE>
<CAPTION>
*
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 12/06/00 J 2,000 A $0.3125 2,086,045 D See Note #1
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Common Stock 12/13/00 J 123,034 A $0.15 2,209,079 D See Note #1
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Common Stock 10/31/00 J 3,316,082 A $0.0 3,316,082 I See Note #2
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
<PAGE>
<TABLE>
<CAPTION>
FORM 4 (continued)
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Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Common
Stock Options -- 12/01/00 A 75,000 -- 12/01/03 Stock 75,000 $0.24 2,205,335 D
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Common
Stock Options -- 12/01/00 A 159,500 -- 12/01/03 Stock 159,500 $0.22 159,500 I See Note #4
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Common
Warrants -- 10/31/00 A 604,237 -- -- Stock -- -- 604,237 I See Note #3
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</TABLE>
Explanation of Responses:
Note #1 - Held by the Reporting Person as Trustee for the Company and subject to
an Escrow Agreement by and between the Reporting Person and the
Company, - 1,902,986
Note #2 - Held by the Reporting Person as Trustee - 3,316,082 for Unaffiliated
Parties.
Note #3 - Held by the Reporting Person as Trustee - 604,237 for Unaffiliated
Parties.
Note #4 - Held by the Reporting Person or Trustee - 159,500 for Unaffiliated
Parties
/s/ Thomas F. Reiner 12/18/00
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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 provided is insufficient, see Instruction 6 for procedures.
