UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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 control number. |
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 Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Options (Right to Buy) | 06/12/2007(2) | 06/12/2016 | Common Stock | 10,000 | $ 36.52 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
LOWELL WAYNE B 2277 FAIR OAKS BOULEVARD, SUITE 440 SACRAMENTO, CA 95825 |
 X |  |  |  |
Wayne Lowell, by Jeff D. Barlow, Attorney-in-Fact. | 06/14/2006 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | 1,000 of the listed shares are fully vested. The remaining 4,011 shares were granted under the Molina Healthcare, Inc. 2002 Equity Incentive Plan in connection with the reporting person's election to the board of directors, with 261 shares vesting on June 30, 2006, and 1,250 shares vesting on each of September 30, 2006, December 31, 2006, and March 31, 2007. |
(2) | The options were granted under the Molina Healthcare, Inc. 2002 Equity Incentive Plan in connection with the reporting person's election to the board of directors, with one-third of the options to vest on each of 6/12/2007, 6/12/2008, and 6/12/2009. |