U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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 Reporting Person*
Blutt Mitchell J.
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(Last) (First) (Middle)
Chase Equity Associates, LLC ("CEA, LLP")(1)
380 Madison Avenue, 12th Floor
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(Street)
New York, New York 10017
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
1/1/2000
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3. IRS Identification Number of Reporting Person, if an entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
Fisher Scientific International, Inc. ("FSH")
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
|X| Director |_| 10% Owner
|_| Officer (give title below) |_| Other (specify below)
________________________________________
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6. If Amendment, Date of Original (Month/Day/Year)
1/21/98
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7. Individual or Joint/Group Filing (Check applicable line)
|X| Form filed by One Reporting Person
|_| Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 5) (Instr. 5) (Instr. 5)
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<S> <C> <C> <C>
Nonvoting Common Stock 807,058 I (2)
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</TABLE>
* If the Form is filed by more than one Reporting Person see instruction
5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
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<PAGE>
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 7. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Nonvoting Common Stock 1/21/98 1/21/2008 Nonvoting Common 66,409 $48.25 I (2)
Warrants Stock
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</TABLE>
Explanation of Responses:
(1) Pursuant to an internal reorganization effective as of January 1, 2000, (i)
Chase Equity Associates, LLC ("CEA, LLC") became the successor to Chase Equity
Associates, LP ("CEA, LP"), and (ii) CCP-CMC Consolidating, LLC
("Consolidating"), a newly-organized affiliate of Chase Capital Partners
("CCP"), became the sole member of CEA, LLC. Dr. Blutt is a general partner of
CCP. CCP is the managing member of Consolidating, and pursuant to a master
advisory agreement with Consolidating, the manager, by delegation, of CEA, LLC.
Prior to the internal reorganization, CCP was the general partner, and the sole
shareholder of Consolidating was the limited partner, of CEA, LP. The internal
reorganization changed CEA, LP's name and form of organization but did not alter
the proportionate interests of its ultimate security holders.
(2) CEA, LLC is the record owner of the shares. Dr. Blutt disclaims beneficial
ownership of such securities except to the extent of his pecuniary interest
therein.
/s/ Mitchell J. Blutt, MD February , 2000
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** Signature of Reporting Person 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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