U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENFICIAL OWNERSHIP
1. Name and Address of Reporting Person:
Phillip L. McStotts, 746 Quaking Aspen, Murray, UT 84123
2. Issuer Name and Ticker or Trading Symbol:
ZEVEX International, ZVXI.
3. IRS or Social Security Number of Reporting Person (Voluntary):
4. Statement for Month/Year:
12/99
5. If Amendment, Date of Original (Month/Year):
6. Relationship of Reporting Person to Issuer (Check all applicable):
(X) Director (X) Officer (give title below) ( ) 10% Owner
( ) Other (specify below)
Title: Chief Financial Officer
TABLE I -- Non-Derivative Securities Beneficially Owned
<TABLE>
<CAPTION>
<S> <C> <C> <C> <C> <C> <C>
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount 6. Owner- 7. Nature
action action or Disposed of (D) of ship of In-
Date Code Securities Form direct
(M/D/Y) Beneficially Direct Benefic-
Owned at (D) or ial
End of Indirect Owner-
Amount (A) or (D) Price Month (I) ship
- --------------------- ------------ ------------ -------------------------- ------------ --------- ------------
</TABLE>
<TABLE>
<CAPTION>
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
<CAPTION> TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of 2. Conver- 3.Trans- 4. Trans- 5. Number of 6. Date 7. Title and 8. Price 9. Num- 10. Own- 11. Na-
Deriv- sion or action action Derivative Exer- and Am- of ber of ership ture
ative Exercise Date Code Securities cisable ount of Deriv- Deriv- Form of In-
Security Price of (M/D/Y) Acquired and Ex- Under- ative ative of De- direct
Deriv- (A) or Dis- piration lying Secur- Secur- rivative Benef-
ative posed of (D) Date Securities ity ities Security: icial
Security (M/D/Y) Bene- Direct (D) Own
---------- ------------ ficially or Indirect ership
Date Epir- Title Amount Owned (I)
Exer-ation or Number at End of
cisable Date of shares Month
- ----------- ----------- --------- -------- -------------- ------------ ------------- ------ ---------- ---------- ---------
Employee
Stock
Option
(Right to
Buy) 5.0000 1/08/99 A* 10,000 1/01/00 10/07/08 Common Stock 10,000 0
Employee
Stock
Option
(Right to
Buy) 5.0000 1/01/00 A* 10,000 1/01/01 10/07/08 Common Stock 10,000 0
Employee
Stock
Option
(Right to
Buy) 5.0000 1/01/01 A* 10,000 1/01/02 10/07/08 Common Stock 10,000 0 30,000 D
</TABLE>
*All of the Option Shares shall become purchasable by the Optionee the date
which is nine years and nine months following the Grant Date if the Optionee is
continuously in the Service of the Corporation during that time. Additionally,
one-third of the Option Shares (10,000 shares or a portion thereof, as described
below) shall become purchasable following each of the first three anniversary
dates of the Grant Date upon the Corporation's achieving certain annual revenue
and earnings in the three fiscal years ending December 31, 1999, 2000, and 2001.
