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U. S. SECURITIES AND EXCHANGE COMMISSION
FORM 5
[ ] Check box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. Washington, D.C. 20549
See instruction 1(b).
[ ] Form 3 Holdings Reported. ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] Form 4 Transactions Reported.
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 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Reporting Person* Issuer (Check all applicable)
LabOne, Inc. (LABS)
X Director ___ 10% Owner
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for X Officer ___ Other
Number of Reporting Month/Year --- (give title (specify
Grant II, W. Thomas Person (Voluntary) 12/1999 below) below)
Chairman of the Board of Directors,
President, Chief Executive Officer and
Class C Director
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(Street) 5. If Amendment, Date of 7. Individual or Joint/Group Filing
Original (Month/Year (Check applicable line)
X Form filed by One Reporting
10101 Renner Boulevard --- Person
___ Form filed by More than One
Reporting Person
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(City) (State) (Zip) Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned.
Leawood, Kansas 66219
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<S> <C> <C> <C> <C> <C> <C>
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action action or Disposed of (D) Securities Form: Indirect
date: Code (Instr. 3, 4 and 5) Beneficially Direct Beneficial
(Month/ (Instr. 8) Owned at (D) or Ownership
Day/ End of Issuer's Indirect (Instr. 4)
Year) Fiscal Year. (I)
(Instr. 3 (Instr. 4)
and 4)
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Amount (A) or Price
(D)
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Common Stock 12,793 D
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Common Stock 63,823 I (1)
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* If the Form is filed by more than one Reporting Person, see instruction 4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly. (Print or Type Responses) Page 1 of 2
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FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants,
options, convertible securities)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1.Title of 2.Conver- 3.Trans- 4.Transac- 5.Number of 6.Date 7.Title 8.Price of 9.Number 10.Owner- 11.Nature
Derivative sion or action tion Code Derivative Exercisable and Amount Derivative of Deriv- ship of In-
Security Exercise Date (Instr. 8) Securities and of Security ative Form of direct
(Inst. 3) Price of (Month/ Acquired Expiration Underlying (Instr. 5) Securities Deriv- Bene-
Deriv- Day/ (A) or Date Securities Beneficial- ative ficial
ative Year) Disposed (Month/Day/ (Instr. 3 ly Owned at Security; Owner-
Security of (D) Year) and 4) End of Direct ship
(Instr.3, Month (D) or (Instr
4, and 5) (Instr. 4) Indirect 4)
(I)
(Instr. 4)
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(A) (D) Date Expira- Title Amount or
Exer- tion Date Number of
cisable Shares
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Explanation of Responses: Includes (a) 35,923 shares of common stock held by Mr. Grant as custodian for his children; (b) 2,473
shares owned by Mr. Grant's wife as to which Mr. Grant disclaims beneficial ownership; and (c) 25,427 shares of common stock held in
an individually directed acount under LabOne's 401(k) profit-sharing plan, as to which Mr. Grant has sole investment power only.
Excludes 67,500 shares held in a family trust for which Mr. Grant serves as a co-trustee and in that capacity shares voting and
investment powers, but has no pecuniary interest.
/s/ W. Thomas Grant II by Randy Shelton as attorney-in-fact February 14, 2000
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** W. Thomas Grant II by Randy Shelton as attorney-in-fact 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 procedure.
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