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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-C
REPORT BY ISSUER OF SECURITIES QUOTED ON NASDAQ
INTERDEALER QUOTATION SYSTEM
Filed pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934 and Rule 13a-17
or 15d-17 thereunder
LIFEQUEST MEDICAL, INC.
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(Exact name of issuer as specified in charter)
9601 McAllister Freeway, Suite 1120, San Antonio, Texas 78216
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(Address of principal executive offices)
Issuer's telephone number, including area code (210) 366-2100
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I. CHANGE IN NUMBER OF SHARES OUTSTANDING
Indicate any change (increase or decrease) of 5% or more in the number of
shares outstanding:
1. Title of Security Common Stock, $.001 par value
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2. Number of shares outstanding before the change 3,793,205
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3. Number of shares outstanding after the change 4,393,205
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4. Effective date of change November 27, 1996
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5. Method of change:
Specify method (such as merger, acquisition exchange, distribution, stock
split, reverse split, acquisition of stock for treasury, etc.)
Issuance of shares
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Give brief description of transaction:
Pursuant to a Plan of Merger, and Acquisition Agreement dated
November 27, 1996 (the "Agreement"), Klein Medical, Inc., a Texas
corporation ("KMI"), was merged with and into Klein Medical
Acquisition Co., a Nevada corporation ("KMAC"), and a wholly
owned subsidiary of LifeQuest Medical Inc., a Delaware
corporation ("LifeQuest"), with KMAC as the surviving
corporation. As provided in the Agreement, all the issued and
outstanding shares of KMI common stock, $1.00 par value, were
converted into the right to receive an aggregate of 600,000
shares of LifeQuest common stock, $.001 par value.
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II. CHANGE IN NAME OF ISSUER
6. Name prior to change N/A
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7. Name after change N/A
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8. Effective date of charter amendment changing name N/A
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9. Date of shareholder approval of change, if required N/A
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Date: December 6, 1996 /s/ Randall K. Boatright
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(Officer's signature)
Title: Vice President and
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Chief Financial Officer
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