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OMB APPROVAL
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OMB Number 3235-0287
Expires: April 30, 1997
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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 this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person
Michaelson, Richard
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(Last) (First) (Middle)
c/o Unilab Corporation
401 Hackensack Avenue
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(Street)
Hackensack, NJ 07601
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Unilab Corporation (ULB)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
October 1997
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ X ] Director [ ] 10% Owner
[ X ] Officer (give title below) [ ] Other (specify below)
As previously reported, Mr. Michaelson was elected to the Board on
September 17, 1997. He will resign from his position as Senior
Vice President-Finance, of Unilab after a transition period, after
which he will become a consultant to the Company.
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock (option exercise) 10/03/97 M 75,000 A $0.625 234,090 D N/A
per share
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
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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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<TABLE>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (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> <C>
Exercise of
Option to Purchase Common
Common Stock $0.625 10/03/97 M 75,000 9/17/97 9/17/07 Stock 75,000 N/A 620,000 D N/A
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Option to Purchase
Common Stock (1) 10/20/92 J 150,000 9/17/97 9/17/07
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Option to Purchase
Common Stock (1) 2/25/94 J 50,000 9/17/97 9/17/07
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Option to Purchase
Common Stock (1) 1/1/95 J 35,000 9/17/97 9/17/07
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Option to Purchase
Common Stock (1) 5/1/95 J 150,000 9/17/97 9/17/07
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Option to Purchase
Common Stock (1) 2/27/96 J 35,000 9/17/97 9/17/07
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Option to Purchase
Common Stock (1) 4/28/97 J 200,000 9/17/97 9/17/07
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</TABLE>
Explanation of Responses: (1) In connection with Mr. Michaelson's transition
from full-time employee to director and consultant of Unilab, the Board of
Directors accelerated the vesting and extended the expiration date of all
outstanding options to purchase Unilab common stock beneficially owned by
Mr. Michaelson. Accordingly, all such options are now deemed fully vested as
of 9/17/97 with an expiration date of 9/17/07.
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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 procedures.
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