U. S. SECURITIES AND EXCHANGE COMMISSION
FORM 5
[ ] Check box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. Washington, D.C. 20549
See instruction 1(b).
[ ] Form 3 Holdings Reported. ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] Form 4 Transactions Reported.
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 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Reporting Person* Issuer (Check all applicable)
LabOne, Inc. (LABS)
Director X 10% Owner
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for Officer ___ Other
Number of Reporting Month/Year --- (give title (specify
Grant, W. D. Person (Voluntary) 2001 below) below)
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(Street) 5. If Amendment, Date of 7. Individual or Joint/Group Filing
Original (Month/Year (Check applicable line)
X Form filed by One Reporting
One Ward Parkway, Suite 130 --- Person
___ Form filed by More than One
Reporting Person
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(City) (State) (Zip) Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned.
Kansas City, Missouri 64112
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action action or Disposed of (D) Securities Form: Indirect
date: Code (Instr. 3, 4 and 5) Beneficially Direct Beneficial
(Month/ (Instr. 8) Owned at (D) or Ownership
Day/ End of Issuer's Indirect (Instr. 4)
Year) Fiscal Year. (I)
(Instr. 3 (Instr. 4)
and 4)
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Amount (A) or Price
(D)
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Common Stock 05/25/2001 A 329 A (1)
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Common Stock 06/30/2001 J(2) 6,820 A 903,217 D
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Common Stock 12/31/2001 J(3) 3,044 A 916,936 I(4)
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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) Page 1 of 2
FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants,
options, convertible securities)
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1.Title of 2.Conver- 3.Trans- 4.Transac- 5.Number of 6.Date 7.Title 8.Price of 9.Number 10.Owner- 11.Nature
Derivative sion or action tion Code Derivative Exercisable and Amount Derivative of Deriv- ship of In-
Security Exercise Date (Instr. 8) Securities and of Security ative Form of direct
(Inst. 3) Price of (Month/ Acquired Expiration Underlying (Instr. 5) Securities Deriv- Bene-
Deriv- Day/ (A) or Date Securities Beneficial- ative ficial
ative Year) Disposed (Month/Day/ (Instr. 3 ly Owned at Security; Owner-
Security of (D) Year) and 4) End of Direct ship
(Instr.3, Month (D) or (Instr
4, and 5) (Instr. 4) Indirect 4)
(I)
(Instr. 4)
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(A) (D) Date Expira- Title Amount or
Exer- tion Date Number of
cisable Shares
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Explanation of Responses: (1) 329 shares were awarded to Mr. Grant as compensation for acting as a director; (2) 3,410 shares were
distributed to Mr. Grant and 3,410 shares were distributed to Mr. Grant's wife by four charitable trusts of which Mr. and Mrs. Grant
are beneficiaries; shares paid in July 2001; (3) 1,522 shares were distributed to Mr. Grant and 1,522 shares were distributed to Mr.
Grant's wife by four charitable remainder trusts of which Mr. and Mrs. Grant are beneficiaries; shares paid in January 2002; and (4)
Includes (a) 478,237 shares held by three family trusts for which Mr. Grant, as co-trustee, shares voting and investment power with
UMB Bank, N.A.; (b) 295,158 shares held by two family trusts as to which Mr. Grant has the right to direct the voting and
disposition of such shares and therefore shares voting and investment powers with the trustee, UMB Bank, N.A., (c) 82,892 shares
owned by Mr. Grant's wife, as to which Mr. Grant disclaims beneficial ownership; and (d) 60,649 shares held by a family trust for
Mr. Grant's niece, for which Mr. Grant, as co-trustee, shares voting and investment power with UMB Bank, N.A., as to which shares
Mr. Grant does not have a pecuniary interest. Mr. Grant disclaims beneficial ownership of any shares owned by Welsh, Carson,
Anderson & Stowe, IX, L.P. ("WCAS IX") and its affiliates which WCAS IX is required to vote in accordance with the voting agreement
between members of the Grant Family and WCAS IX.
/s/ William D. Grant February 8, 2002
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William D. Grant 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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