-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TfavtDcYlERhQr8/kq0/RnkACKkB6LM3z1GZ36zaxY4HaM5qoti6R0vUqzSgrkt/ jv/rvyTDFyqHUAQ76vBGIw== 0000897464-98-000002.txt : 19980129 0000897464-98-000002.hdr.sgml : 19980129 ACCESSION NUMBER: 0000897464-98-000002 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19971218 DATE AS OF CHANGE: 19980128 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PACE HEALTH MANAGEMENT SYSTEMS INC CENTRAL INDEX KEY: 0000943324 STANDARD INDUSTRIAL CLASSIFICATION: 7372 IRS NUMBER: 421297992 STATE OF INCORPORATION: IA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: SEC FILE NUMBER: 005-44295 FILM NUMBER: 98510498 BUSINESS ADDRESS: STREET 1: 1025 ASHWORTH RD STREET 2: STE 200 CITY: WEST DES MOINES STATE: IA ZIP: 50265 BUSINESS PHONE: 5152221717 MAIL ADDRESS: STREET 1: 1025 ASHWORTH RD STREET 2: SUITE 200 CITY: W DES MOINES STATE: IA ZIP: 50265 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: PAPPAJOHN JOHN CENTRAL INDEX KEY: 0000897464 STANDARD INDUSTRIAL CLASSIFICATION: FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: C/O EQUITY DYNAMICS STREET 2: 2116 FINANCIAL CENTER CITY: DES MOINES STATE: IA ZIP: 50309 MAIL ADDRESS: STREET 1: 2116 FINANCIAL CENTER STREET 2: C/O EQUITY DYNAMICS CITY: DES MOINES STATE: IA ZIP: 50309 SC 13D 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D Under the Securities Exchange Act of 1934 Amendment No. 5 PACE HEALTH MANAGEMENT SYSTEMS, INC. (Name of Issuer) Convertible Preferred Stock, Series A (Title Class of Securities) 693723108 (CUSIP Number) Mr. John Pappajohn Equity Dynamics, Inc. 2116 Financial Center Des Moines, Iowa 50309 515-244-5746 (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) December 8, 1997 (Date of Event which Requires Filing of this Statement) Check the following box if a fee is being paid with this statement: / / (1) NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON John Pappajohn ###-##-#### (2) CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) / / (b) / / (3) SEC USE ONLY (4) SOURCE OF FUNDS PF (5) CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e) / / (6) CITIZENSHIP OR PLACE OR ORGANIZATION U.S.A. NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH: (7) SOLE VOTING POWER 933,471 (8) SHARED VOTING POWER 0 (9) SOLE DISPOSITIVE POWER 933,471 (10) SHARED DISPOSITIVE POWER 0 (11) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 933,471 (12) CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES / / (13) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 11 16.24% (14) TYPE OF REPORTING PERSON IN SCHEDULE 13D This amends and supplements the Statement on Schedule 13D filed with the Commission by John Pappajohn (the "Purchaser") with respect to his ownership of Common Stock (the "Common Stock"), no par value per share, Convertible Preferred Stock, Series A, no par value per share ("Series A Preferred Stock") and Warrants to purchase shares of Common Stock (the "Warrants") of PACE Health Management Systems, Inc., an Iowa Corporation (the "Company"). Unless otherwise defined herein, all capitalized items used herein shall have the meaning ascribed to them in the Statement. Item 5. Interest in Securities of the Issuer (a) As of the date of this Statement, the Purchaser beneficially owned an aggregate of 508,519 shares of Common Stock, 214,286 shares of Series A Preferred Stock and Warrants to purchase another 210,666 shares of Common Stock. Such shares of Common Stock and the Warrants represent 16.24% of the outstanding Common Stock of the Company based upon 5,746,736 shares of Common Stock actually outstanding as of December 8, 1997, assuming conversion of all of the Purchaser's Series A Preferred Stock and Warrants into Common Stock. b) The Purchaser has sole power to vote or direct the vote and sole power to dispose or direct the disposition of all shares of Common Stock and Series A Preferred Stock that he owns. (c) On December 8, 1997 the Purchaser received Warrants to purchase 71,429 shares of the Company's Common Stock at $1.375. The Warrants were issued in connection with the Purchaser's personal guaranty of $500,000 of the Company's debt. (d - e) Not applicable. Item 6. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of Issuer Not applicable. Item 7. Material to be Filed as Exhibits Not applicable. Item 8. Certification and Signature: After reasonable inquiry and to the best of my knowledge and belief, the undersigned certifies that the information set forth in this Statement is true, complete and correct. Dated: December 8, 1997 /s/ John Pappajohn - - - ------------------- John Pappajohn -----END PRIVACY-ENHANCED MESSAGE-----