4/A: Statement of changes in beneficial ownership of securities
Published on February 10, 2000
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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 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*
Kellman Franklin S.
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(Last) (First) (Middle)
900 Victors Way, Suite 350
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(Street)
Ann Arbor MI 48108
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Omega Healthcare Investors, Inc. (OHI)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
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5. If Amendment, Date of Original (Month/Year)
December, 1999
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [_] 10% Owner
[x] Officer (give title below) [_] Other (specify below)
Chief Operating Officer
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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 Acquired, Disposed of,
or Beneficially Owned
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* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
(Over)
(Form 4-07/98)
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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Explanation of Responses:
*In exchange for a payment of $8,035.93, representing $.06 per option share
as to the $34.7948 grant and $.11 per option share for the $30.2103 and
$30.1875 grants, the expiration date of outstanding options was accelerated
to December 2, 1999.
/s/ F. Scott Kellman February 10, 2000
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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.
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