| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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(h) of the Investment Company Act of 1940 | | OMB APPROVAL | | OMB Number: | 3235-0104 | | Expires: | February 28, 2011 | | Estimated average burden | | hours per response | 0.5 |
|
|
1. Name and Address of Reporting Person*
| 3200 WINDY HILL ROAD, SUITE B-100 | |
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year)
09/24/2009 | 3. Issuer Name and Ticker or Trading Symbol
INVERNESS MEDICAL INNOVATIONS INC
[IMA]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable) | Director | | 10% Owner | | X | Officer (give title below) | | Other (specify below) | | Chief Information Officer |
| 5. If Amendment, Date of Original Filed (Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
| X | Form filed by One Reporting Person | | Form filed by More than One Reporting Person |
|
| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
| 2.
Amount of Securities Owned (Instr.
4)
| 3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
| 4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
|---|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities) |
|---|
| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year)
| 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Excercise Price of Derivative Security
| 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)
| 6. Nature of Indirect Beneficial Ownership (Instr. 5)
|
|---|
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
|---|
|
Employee Stock Option (Right to Buy)
| | 08/31/2019 |
Common Stock
|
40,000
|
$
35.6
|
D
| |
|
Employee Stock Option (Right to Buy)
| | 06/30/2019 |
Common Stock
|
12,000
|
$
35.58
|
D
| |
|
Employee Stock Option
| | 12/13/2018 |
Common Stock
|
1,000
|
$
18.91
|
D
| |
|
Employee Stock Option (Right to Buy)
| | 06/30/2018 |
Common Stock
|
25,000
|
$
33.17
|
D
| |
|
Series B Convertible Perpetual Preferred Stock
| | |
Common Stock
|
22,636
|
$
69.32
|
D
| |
| Explanation of Responses: |
|
|
|
|
|
|
|
| /s/ Jay McNamara, Attorney in Fact | 10/02/2009 |
| ** Signature of Reporting Person | Date |
| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
| * If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
| ** 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 is insufficient,
see Instruction 6 for procedure. |
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
EXHIBIT 24
LIMITED POWER OF ATTORNEY
FOR SECTION 16(a) FILINGS
Know all by these presents, that the undersigned hereby
constitutes and Appoints each of Paul Hempel, Jay McNamara and
Katie Garrett, signing singly, the undersigned's
only true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the
undersigned's capacity as an officer, director and/or stockholder
of Inverness Medical Innovations, Inc. (the "Company"), Forms 3, 4,
and 5 and amendments thereto in accordance with Section 16(a) of
the Securities Exchange Act of 1934 and the rules thereunder;
(2) do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and
execute any such Form 3, Form 4, or Form 5 and any amendments
thereto and timely file such forms with the United States
Securities and Exchange Commission and any stock exchange or
similar authority; and
(3) take any other action of any type whatsoever which, in the opinion
of such attorney-in-fact, may be necessary or desirable in connection
with the foregoing authority, it being understood that the documents
executed by such attorney-in-fact on behalf of the undersigned pursuant
to this Power of Attorney shall be in such form and shall contain such
terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of
the rights and powers herein granted, as fully to all intents and
purposes as the undersigned might or could do if personally present,
with full power of substitution or revocation, hereby ratifying and
confirming all that such attorney-in-fact, or such attorney-in-fact's
substitute or substitutes, shall lawfully do or cause to be done by
virtue of this Power of Attorney and the rights and powers herein
granted. The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of
the undersigned, are not assuming, nor is the Company assuming, any of
the undersigned's responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5with
respect to the undersigned's holdings of and transactions in
securities issued by the Company, unless earlier revoked by the
undersigned in a signed writing delivered to the foregoing
attorneys-in-fact. This Power of Attorney may be filed with the SEC
as a confirming statement of the authority granted herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 25th day of January, 2009.
/s/ Thomas Underwood
Thomas Underwood, Chief Information Officer