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FORM 4 U.S. Securities and Exchange Commission OMB APPROVAL
Washington, D.C. 20549 OMB Number: 3235-0287
/_/ Check this box if no longer Expires:September 30, 1998
subject to Section 16. Form 4 or STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden
Form 5 obligations may continue. hours per response..... 0.5
See Instruction 1(b). 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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<S> <C> <C>
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to
Issuer (Check all applicable)
Jenkins, T. Scott INTEGRATED MEDICAL RESOURCES, INC. (IMRI) /X/ Director ___ 10% Owner
- ---------------------------------------- -------------------------------------------- /X/ Officer (give) ___ Other (specify
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for title below) below)
Number of Reporting Month/Year President and Chief Operating Officer
4800 West 81st Street Person (Voluntary)
- ---------------------------------------- August 1997
(Street) ###-##-#### ------
5. If Amendment, 7. Individual or Joint/Group Filing
Prairie Village, KS 66208 Date of Original (Check Applicable Line)
- ---------------------------------------- (Month/Year) /X/ Form filed by One Reporting Person
(City) (State) (Zip) /_/ Form filed by More than One
Reporting Person
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TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
<S> <C> <C> <C> <C> <C> <C>
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1. TITLE OF 2. TRANSACTION 3. TRANSACTION 4. SECURITIES 5. AMOUNT OF 6. OWNERSHIP 7. NATURE OF
SECURITY DATE CODE ACQUIRED (A) OR SECURITIES FORM: INDIRECT
(Instr. 3) (Month/Day/Year) (Instr. 8) DISPOSED OF (D) BENEFICIALLY DIRECT (D) BENEFICIAL
(Instr. 3, 4 and 5) OWNED AT END OR OWNERSHIP
------------- -------------------------- OF MONTH INDIRECT (I) (Instr. 4)
Code V Amount (A) or (D) Price (Instr.3 and 4) (Instr. 4)
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Common Stock 8-14-97 S 20,000 D $2 205,750 D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly (Over)
(Print or Type Responses)
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v).
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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 SECURITY (Instr. 3):
2. CONVERSION OR EXERCISE PRICE OF DERIVATIVE SECURITY:
3. TRANSACTION DATE: (MONTH/DAY/YEAR)
4. TRANSACTION CODE (Instr. 8):
5. NUMBER OF DERIVATIVE SECURITIES ACQUIRED (A) OR DISPOSED OF (D) (Instr. 3, 4, and 5):
6. DATE EXERCISABLE AND EXPIRATION DATE (MONTH/DAY/YEAR):
7. TITLE AND AMOUNT OF UNDERLYING SECURITIES (Instr. 3 and 4):
8. PRICE OF DERIVATIVE SECURITY (Instr. 5):
9. NUMBER OF DERIVATIVE SECURITIES BENEFICIALLY OWNED AT END OF MONTH (Instr. 4):
10. OWNERSHIP FORM OF DERIVATIVE SECURITY DIRECT (D) OR INDIRECT (I) (Instr. 4):
11. NATURE OF INDIRECT BENEFICIAL OWNERSHIP (Instr. 4):
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Explanation of Responses:
/s/ T. Scott Jenkins 9/02/97
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**Signature of Reporting Person Date
T. Scott Jenkins
** 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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