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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
ANNUAL 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 box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
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1. Name and Address of Reporting Person*
The Goldman Sachs Group, L.P.
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(Last) (First) (Middle)
85 Broad Street
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(Street)
New York, New York 10004
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Neuromedical Systems, Inc.
(NSIX)
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3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Year
FYE December 31, 1998
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ ] Director [ X ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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7. Individual or Joint/Group Reporting
(Check applicable line)
[ ] Form Filed by One Reporting Person
[ X ] Form Filed by More than One Reporting Person
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<TABLE>
<CAPTION>
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Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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| | | | | | |
| | | |5. |6. | |
| | |4. |Amount of |Owner- | |
| | |Securities Acquired (A) or |Securities |ship | |
| | |Disposed of (D) |Beneficially |Form: |7. |
| | |(Instr. 3, 4 and 5) |Owned at end |Direct |Nature of |
|2. | 3. |-------------------------------|of Issuer's |(D) or |Indirect |
1. |Transaction |Transaction | | (A) | |Fiscal Year |Indirect |Beneficial|
Title of Security |Date |Code | Amount | or | Price |(Instr. 3 |(I) |Ownership |
(Instr. 3) |(Month/Day/Year) |(Instr. 8) | | (D) | |and 4) |(Instr.4)|(Instr. 4)|
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
| | | | | | | | |
Common Stock | | | | | | 6,839,699 | 01 | 01 |
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| | | | | | | | |
| | | | | | | | |
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one Reporting Person, see Instruction
4(b)(v).
FORM 5 (continued)
<TABLE>
<CAPTION>
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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|
|or | | |Derivative |6. |of Underlying |8. |ities |Secur-|of |
|Exer- | | |Securities |Date |Securities |Price |Bene- |ity: |In- |
|cise |3. | |Acquired (A) |Exercisable and |(Instr. 3 and 4) |of |ficially |Direct|direct|
|Price |Trans- |4. |or Disposed |Expiration Date |--------------------|Deriv- |Owned |(D) or|Bene- |
1. |of |action |Trans-|of (D) |(Month/Day/Year) | |Amount |ative |at End |In- |ficial|
Title of |Deriv- |Date |action|(Instr. 3, |---------------------| |or |Secur- |of |direct|Owner-|
Derivative |ative |(Month/ |Code |4 and 5) |Date |Expira- | |Number |ity |Year |(I) |ship |
Security |Secur- |Day/ |(Instr|---------------|Exer- |tion | |of |(Instr.|(Instr. |(Instr|(Instr|
(Instr. 3) |ity |Year) |8) | (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>
Director Stock| | | | | | | | | | | | | |
Options (right| | | | | | | | | | | | | |
to buy) |$2.12 | 5/8/98 | A(02)| 2,500 | | 11/9/98 | 5/8/08 |Common Stock| 2,500 | | 2,500 | 02 | 02 |
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Director Stock| | | | | | | | | | | | | |
Options (right| | | | | | | | | | | | | |
to buy) |$7.375 | | | | | 11/17/97 | 5/16/07 |Common Stock| 5,000 | | 5,000 | 02 | 02 |
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Director Stock| | | | | | | | | | | | | |
Options (right| | | | | | | | | | | | | |
to buy) |$16.88 | | | | | 12/22/96 | 6/21/06 |Common Stock| 5,000 | | 5,000 | 02 | 02 |
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Director Stock| | | | | | | | | | | | | |
Options (right| | | | | | | | | | | | | |
to buy) |$7.00 | | | | | 4/26/96 | 10/25/05 |Common Stock| 2,500 | | 2,500 | 02 | 02 |
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Director Stock| | | | | | | | | | | | | |
Options (right| | | | | | | | | | | | | |
to buy) |$6.00 | | | | | 6/1/95 | 6/1/05 |Common Stock| 2,500 | | 2,500 | 02 | 02 |
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</TABLE>
Instruction 4(b)(v) list of other Reporting Persons:
This statement is being filed by GS Capital Partners, L.P. ("GSCP"), Stone
Street Fund 1993, L.P. ("Stone Street 1993"), Bridge Street Fund 1993, L.P.
("Bridge Street 1993" and, together with GSCP and Stone Street 1993, the
"Limited Partnerships"), GS Advisors, L.P. ("GS Advisors"), Stone Street
Resource Corp. ("Resource"), Goldman, Sachs & Co. ("Goldman Sachs") and The
Goldman Sachs Group, L.P. ("GS Group" and, together with GSCP, GS Advisors,
Stone Street 1993, Bridge Street 1993, Resource and Goldman Sachs, the
"Reporting Persons"). The principal business address of each of the Reporting
Persons is 85 Broad Street, New York, NY 10004.
Explanation of Responses:
01: GS Group may be deemed to own beneficially and directly 125,000 shares of
Common Stock and Goldman Sachs and GS Group may be deemed to own beneficially
and indirectly in the aggregate 6,714,699 shares of Common Stock through the
Limited Partnerships. GS Group is the general partner of and owns a 99% interest
in Goldman Sachs. Goldman Sachs is the investment manager of GSCP. Affiliates of
Goldman Sachs and GS Group are the general partner, managing general partner or
managing partner of the Limited Partnerships. Goldman Sachs and GS Group each
disclaim beneficial ownership of the shares of Common Stock owned by the Limited
Partnerships except to the extent of their pecuniary interest therein.
GSCP may be deemed to own beneficially and directly, and its general partner GS
Advisors may be deemed to own beneficially and indirectly, 5,371,758 shares of
Common Stock. GS Advisors disclaims beneficial ownership of the securities
reported herein except to the extent of its pecuniary interest therein.
Stone Street 1993 may be deemed to own beneficially and directly, and its
general partner Resource may be deemed to own beneficially and indirectly,
634,673 shares of Common Stock. Resource disclaims beneficial ownership of the
securities reported herein except to the extent of its pecuniary interest
therein.
Bridge Street 1993 may be deemed to own beneficially and directly and its
managing general partner Resource may be deemed to own beneficially and
indirectly, 708,268 shares of Common Stock. Resource disclaims beneficial
ownership of the securities reported herein except to the extent of its
pecuniary interest therein.
02: These options were granted under the Neuromedical Systems, Inc. 1993 Stock
Incentive Plan to a managing director and a former officer of Goldman Sachs in
their capacity as directors of the Issuer. That managing director and that
former officer have an agreement with GS Group pursuant to which they hold the
options for the benefit of GS Group.
Signatures:
GOLDMAN, SACHS & CO.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
THE GOLDMAN SACHS GROUP, L.P.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
GS CAPITAL PARTNERS, L.P.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
GS ADVISORS, L.P.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
STONE STREET FUND 1993, L.P.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
BRIDGE STREET FUND 1993, L.P.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
STONE STREET RESOURCE CORP.
By: s/ Hans L. Reich
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Name: Hans L. Reich
Title: Attorney-in-fact
Date: February 16, 1999
** 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.
Alternatively, this Form is permitted to be submitted to the Commission in
electronic format at the option of the Reporting Person pursuant to Rule
101(b)(4) of Regulation S-T.
