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Aaron Boxer Revocable Trust/Aaron Boxer – ‘SC 13G/A’ on 2/13/01 re: Cardia, Inc.

On:  Tuesday, 2/13/01, at 2:32pm ET   ·   Accession #:  897101-1-131   ·   File #:  5-56443

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  As Of                Filer                Filing    For·On·As Docs:Size              Issuer               Agent

 2/13/01  Aaron Boxer Revocable Tr/A… Boxer SC 13G/A               1:9K   Cardia, Inc.                      American Fin’l P… Inc/FA

Amendment to Statement of Beneficial Ownership   —   Schedule 13G
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: SC 13G/A    Amendment to Statement of Beneficial Ownership         5     20K 


Document Table of Contents

Page (sequential) | (alphabetic) Top
 
11st Page   -   Filing Submission
3Item 1(a). Name of Issuer:
"Item 1(b). Address of Issuer's Principal Executive Offices:
"Item 2(a). Name of Person Filing:
"Item 2(b). Address of Principal Business Office Or, If None, Residence:
"Item 2(c). Citizenship:
"Item 2(d). Title of Class of Securities:
"Item 2(e). Cusip Number:
"Item 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR 13d-2(b), CHECK WHETHER THE PERSON IS A:
4Item 4. Ownership
"Item 5. Ownership of Five Percent or Less of A Class
"Item 6. Ownership of More Than Five Percent on Behalf of Another Person
"Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company
"Item 8. Identification and Classification of Members of the Group
5Item 9. Notice of Dissolution of Group
"Item 10. Certification
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 -------------------- SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 1)(1) CARDIA, INC. ---------------------------------------------------- (Name of Issuer) COMMON STOCK, $.01 PAR VALUE ---------------------------------------------------- (Title of Class of Securities) 14140R 10 2 ---------------------------------------------------- (CUSIP Number) DECEMBER 31, 2000 -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of This Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: |_| Rule 13d-1(b) |X| Rule 13d-1(c) |_| Rule 13d-1(d) ------------------------ (1) The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the NOTES).
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CUSIP NO. 14140R 10 2 13G PAGE 2 OF 5 PAGES 1. NAMES OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) Aaron Boxer Revocable Trust (SSN# 395-38-2219) 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| 3. SEC USE ONLY 4. CITIZENSHIP OR PLACE OF ORGANIZATION U.S.A. 5. SOLE VOTING POWER NUMBER OF 76,072(2) SHARES 6. SHARED VOTING POWER BENEFICIALLY 0 OWNED BY EACH 7. SOLE DISPOSITIVE POWER REPORTING PERSON 76,072(2) WITH 8. SHARED DISPOSITIVE POWER 0 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 76,072(2) 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* |_| (2) Includes 68,289 shares that were previously reported as being held by Aaron Boxer, individually; includes 7,783 shares that were previously reported as having shared voting power and shared dispositive power.
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CUSIP NO. 14140R 10 2 13G PAGE 3 OF 5 PAGES 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 6.3% 12. TYPE OF REPORTING PERSON* OO ITEM 1(a). NAME OF ISSUER: Cardia, Inc. ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 13770 Frontier Court Burnsville, Minnesota 55337 ITEM 2(a). NAME OF PERSON FILING: See Item 1 on cover page ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 7287 Sidonia Court Boca Raton, FL 33433 ITEM 2(c). CITIZENSHIP: See Item 4 on cover page ITEM 2(d). TITLE OF CLASS OF SECURITIES: Common Stock, $.01 par value ITEM 2(e). CUSIP NUMBER: See cover page ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR 13d-2(b), CHECK WHETHER THE PERSON IS A: (a) |_| Broker or dealer registered under Section 15 of the Act, (b) |_| Bank as defined in Section 3(a)(6) of the Act, (c) |_| Insurance Company as defined in Section 3(a)(19) of the Act, (d) |_| Investment Company registered under Section 8 of the Investment Company Act, (e) |_| Investment Adviser registered under Section 203 of the Investment Advisers Act of 1940, (f) |_| Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; SEE 13d-1(b)(1)(ii)(F), (g) |_| Parent Holding Company, in accordance with Rule 13d-1(b)(ii)(G); SEE Item 7,
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CUSIP NO. 14140R 10 2 13G PAGE 4 OF 5 PAGES (h) |_| A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act, (i) |_| A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940, (j) |_| Group, in accordance with Rule 13d-1(b)(1)(ii)(J). If this statement is filed pursuant to Rule 13d-1(c), check this box. |X| ITEM 4. OWNERSHIP. If the percent of the class owned, as of December 31 of the year covered by the statement, or as of the last day of any month described in Rule 13d-1(b)(2), if applicable, exceeds five percent, provide the following information as of that date and identify those shares which there is a right to acquire. (a) Amount beneficially owned: See Item 9 on cover page (b) Percent of class: See Item 11 on cover page (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: See Item 5 on cover page (ii) Shared power to vote or to direct the vote: See Item 6 on cover page (iii) Sole power to dispose or to direct the disposition of: See Item 7 on cover page (iv) Shared power to dispose or to direct the disposition of: See Item 8 on cover page ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. Not applicable ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not applicable ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. Not applicable
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CUSIP NO. 14140R 10 2 13G PAGE 5 OF 5 PAGES ITEM 9. NOTICE OF DISSOLUTION OF GROUP. Not applicable ITEM 10. CERTIFICATION. By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: February 9, 2001 AARON BOXER REVOCABLE TRUST By: /s/ Aaron Boxer ------------------------------ Aaron Boxer, Trustee The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative, other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement, PROVIDED, HOWEVER, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name of any title of each person who signs the statement shall be typed or printed beneath his signature. NOTE: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See ss. 240.13d-7(b) for other parties for whom copies are to be sent. ATTENTION: Intentional misstatements or omissions of fact constitute federal criminal violations (SEE 18 U.S.C. 1001).

Dates Referenced Herein   and   Documents Incorporated by Reference

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This ‘SC 13G/A’ Filing    Date First  Last      Other Filings
Filed on:2/13/01SC 13G/A
2/9/015
12/31/001
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Filing Submission 0000897101-01-000131   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

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