3: Initial statement of beneficial ownership of securities
Published on May 3, 2001
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*
O'Donovan DeAnn L.
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(Last) (First) (Middle)
1719 Tudor Drive
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(Street)
Ann Arbor MI 48103
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
April 24, 2001
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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
Omega Healthcare Investors, Inc. (OHI)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[_] Director [_] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
Vice President
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6. If Amendment, Date of Original (Month/Day/Year)
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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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* 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.
(Print of Type Responses)
(Over)
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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Explanation of Responses:
Options to acquire 25,000 shares of Common Stock at an exercise price of $6.25
per share were granted to the undersigned on July 17, 2000. Options are
exercisable as to thirty percent (30%) as of December 31, 2000 and an additional
1/60th (one-sixtieth) for each month of service completed following December 31,
2001. Dividend Equivalent Rights will accrue on these options when dividends are
paid provided that certain performance goals are achieved. The Dividend
Equivalent Rights will vest on the same vesting schedule as the accompanying
options. These options expire 10 years from grant date.
/s/ DeAnn O'Donovan May 3, 2001
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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.
(Print of Type Responses)
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