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- ------ U.S. SECURITIES AND EXCHANGE COMMISSION ------------------------------
FORM 4 WASHINGTON, DC 20549 OMB APPROVAL
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STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287
[ ] Check this box if no Expires: September 30, 1998
longer subject to Filed pursuant to Section 16(a) of the Securities Estimated average burden
Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the hours per response.........0.5
or Form 5 obligations Public Utility Holding Company Act of 1935 ------------------------------
may continue. See or Section 30(f) of the Investment Company
Instruction 1(b). Act of 1940
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
Larsen Dennis E. Spacelabs Medical, Inc. to Issuer (check all applicable)
- -------------------------------------------- ---------------------------------------------- Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
14315 NE 61st Street Number of Reporting Month/Year X Officer Other (specify
- -------------------------------------------- Person (Voluntary) ---- --- below)
(Street) ------------------- (give title below)
Redmond WA 98052 5. If Amendment, Vice President, Business Development
- -------------------------------------------- Date of Original ------------------------------------
(City) (State) (Zip) (Month/Year)
August 1999 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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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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
(Instr. 8) Owned at (D) or Ownership
(Month/ End of Month Indirect (Instr. 4)
Day/ --------------------------------------- (Instr. 3 and 4) (I)
Year) Code V Amount (A) or Price (Instr. 4)
(D)
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Common Stock 8/16/99 P 6,000 A $15.00 8,000 D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of 2 (Over)
*If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (7/96)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Expiration Securities Deriv-
Price of (Month/ (Instr. Acquired (A) Date (Instr. 3 and 4) ative
Deriv- Day/ 8) or Disposed (Month/Day/ Secur-
ative Year) of (D) (Instr. Year) ity
Security 3, 4, and 5) (Instr. 5)
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Date Expira- Amount or
-------------------------- Exer- tion Title Number of
Code V (A) (D) cisable Date Shares
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9. Number of 10. Ownership 11. Nature of
Derivative Form of Indirect
Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at End Direct (D) (Instr. 4)
of Month or Indirect (I)
(Instr. 4) (Instr. 4)
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Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. By Eugene V. DeFelice 1/7/00
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- -------
**Signature of Reporting Person Date
Attorney-in-Fact for
Dennis E. Larson
Note: File three copies of this Form, one of which must be manually signed. Page 2
If space provided is insufficient, see Instruction 6 for procedure. SEC 1474 (7-96)
Potential persons who are to respond the the collection of information contained in
this form are not required to respond unless the form displays a currently valid OMB Number.
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