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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
Medaphis Corporation
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(Exact name of Issuer as specified in charter)
2700 Cumberland Parkway, Suite 300, Atlanta, Georgia 30339
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(Address of principal executive offices)
Issuer's telephone number, including area code 770/319-3300
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I. CHANGE IN NUMBER OF SHARES OUTSTANDING
Indicate any change (increase or decrease) of five percent or more in the
number of shares outstanding:
1. Title of security Common Stock, par value $0.01 per share
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2. Number of shares outstanding before the change 65,271,805
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3. Number of shares outstanding after the change 71,483,087
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4. Effective date of change June 29, 1996
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5. Method of change: Merger
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6. Give brief description of transaction: On June 29, 1996, stockholders of
Health Data Services Corporation, a Delaware corporation ("HDS"),
became entitled to receive 0.7912 shares of voting common stock, par value
$0.010 per share of Medaphis Corporation, a Delaware corporation
("Medaphis"), in exchange for each share of HDS common stock, par value
$0.10 per share, each share of HDS Series B Convertible Preferred Stock,
par value $0.10 per share, each share of HDS Series C Convertible
Preferred Stock, par value $0.10 per share, and each share of HDS Series
F Convertible Preferred Stock, par value $0.10 per share, upon the
consummation of the merger of HDSSub, Inc., a Delaware corporation and a
wholly-owned subsidiary of Medaphis ("HDSSub"), with and into HDS, in
accordance with the terms and conditions of that certain Amended and
Restated Merger Agreement, dated as of May 23, 1996, by and among Medaphis,
HDSSub and HDS (the "Merger Agreement"). Under the terms of the Merger
Agreement, HDSSub was merged with and into HDS and HDS survived the
merger.
II. CHANGE IN NAME OF ISSUER
1. Name prior to change N/A
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2. Name after change N/A
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3. Effective date of Charter amendment changing name N/A
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4. Date of shareholder approval of change, if required N/A
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Date July 3, 1996
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/s/ James S. Douglass
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James S. Douglass
Vice president, Corporation controller and
Chief Accounting Officer
