Form 5

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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    Form 3 Holdings Reported
    Form 4 Transactions Reported

ANNUAL 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(h) of the Investment Company Act of 1940

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Filed By
Romeo and Dye's
Section 16 Filer
www.section16.net



1. Name and Address of Reporting Person*

Farris, Michael R.

2. Issuer Name and Ticker or Trading Symbol
LaserSight Incorporated (LASE)

6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
X Director                                       10% Owner
X Officer (give title below)          Other (specify below)

Chief Executive Officer                           

(Last)      (First)     (Middle)

3300 University Blvd., Suite 140
 

3. I.R.S. Identification Number
of Reporting Person,
if an entity (voluntary)

 

4. Statement for
Month/Year
12/31/02

(Street)

Winter Park, FL 32792

5. If Amendment,
Date of Original
(Month/Year)
 
7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
    Form filed by More than One Reporting Person

(City)     (State)     (Zip)

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 3)

2. Trans-
action
Date
(Month/ Day/
Year)

2A. Deemed
Execution
Date,
if any
(Month/Day/
Year)

3. Trans-
action Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 & 5)

5. Amount of
Securities
Beneficially
Owned at End of Issuer's
Fiscal year
(Instr. 3 & 4)

6. Owner-
ship Form:
Direct (D)
or Indirect (I)
(Instr. 4)

7. Nature of Indirect
Beneficial Ownership
(Instr. 4)

Amount

(A)
or
(D)

Price

Common Stock

 

 

 

 

 

 

416000

D

 

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 4(b)(v).

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FORM 5 (continued)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security

(Instr. 3)

2. Conver-
sion or
Exercise
Price of Derivative Security

3. Trans-
action Date

(Month/
Day/
Year)

3A. Deemed
Execution
Date,
if any
(Month/
Day/
Year)

4. Trans-
action
Code

(Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D)

(Instr. 3, 4 & 5)

6. Date Exercisable
and Expiration
Date
(Month/Day/
Year)

7. Title and Amount of Underlying Securities
(Instr. 3 & 4)

8. Price of Derivative Security
(Instr. 5)

9. Number of
Derivative
Securities
Beneficially
Owned
at End of Year
(Instr. 4)

10. Owner-
ship Form
of Deriv-
ative
Security:
Direct (D)
or Indirect (I)
(Instr. 4)

11. Nature of Indirect Beneficial Ownership
(Instr. 4)

(A)

(D)

Date Exer-cisable

Expira-
tion
Date

Title

Amount or Number of
Shares

Stock Option (right to buy)

2.06

 

 

 

 

 

 

7/12/06

 

 

 

200000

D

 

Stock Option (right to buy)

5.00

 

 

 

 

 

 

6/9/05

 

 

 

100000

D

 

Stock Option (right to buy)

5.00

 

 

 

 

 

 

12/31/06

 

 

 

107549

D

 

Stock Option (right to buy)

4.375

 

 

 

 

 

 

12/31/06

 

 

 

210000

D

 

Stock Option (right to buy)

4.7813

 

 

 

 

 

 

6/30/03

 

 

 

40000

D

 

Stock Option (right to buy)

7.6875

 

 

 

 

 

 

12/31/06

 

 

 

131250

D

 

Stock Option (right to buy)

13.5

 

 

 

 

 

 

12/31/06

 

 

 

58750

D

 

Stock Option (right to buy)

0.24

5/14/02

 

A

100000

 

 (1)

5/14/12

Common Stock

100000

 

100000

D

 

Explanation of Responses:

(1) 20% on each of 6/10/02, 7/10/02, 8/10/02, 11/10/02 and 5/10/03

  By: /s/ Gregory L. Wilson
             Attorney-in-fact
**Signature of Reporting Person
02/13/03
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 is insufficient, See Instruction 6 for procedure.

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POWER OF ATTORNEY



The undersigned individual hereby constitutes and appoints each of Michael R.

Farris, Gregory L. Wilson and Albert J. Perry the undersigned's true and lawful

attorney-in-fact and agent to execute any and all instruments and documents in

the undersigned's name which such attorney-in-fact may deem necessary or

advisable to comply with Section 16(a) of the Securities Exchange Act of 1934

and any rules of the Securities and Exchange Commission promulgated pursuant

thereto, in connection with the undersigned's direct or indirect ownership of

securities of LaserSight Incorporated, a Delaware corporation (such securities

being referred to herein as "Securities"), including without limitation the

power and authority to sign for the undersigned in the undersigned's name Forms

ID, 3, 4, or 5 and any and all amendments thereto, to file the same, and to take

any other action of any type whatsoever in connection with the foregoing which,

in the judgment of such attorney-in-fact, may be of benefit to, in the best

interest of, or legally required of, the undersigned, 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 their discretion.



The undersigned hereby grants to each such attorney-in-fact full power and

authority to do and perform all and every act and thing whatsoever requisite,

necessary and proper to be done in the exercise of any of the rights and powers

herein granted, as fully to all intents and purposes as such attorney-in-fact

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

their 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 hereby acknowledges that the foregoing attorneys-in-fact, in

serving in such capacity at the request of the undersigned, are not 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 reports pursuant to Section 16 of the

Exchange Act of 1934 with 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.



IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney this

26th day of September, 2002.



           Individual


       /s/ Michael R. Farris

       ---------------------

         [name of insider]