CUSIP NO. 714290103 13G/A PAGE 1 OF 7 PAGES
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SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G/A
Information to be included in Statements filed pursuant
to Rules 13d-1(b), (c), and (d) and
Amendments thereto filed pursuant to Rule 13d-2(b)
(Amendment No. 3)(1)
PERRIGO COMPANY
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(Name of Issuer)
Common Stock, without par value
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(Title of Class of Securities)
714290103
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(CUSIP Number)
December 31, 2003
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(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 on 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 ("Act") 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).
Page 1 of 7 Pages
No Exhibit Index
CUSIP NO. 714290103 13G/A PAGE 2 OF 7 PAGES
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1 NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
Michael J. Jandernoa
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
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NUMBER OF 5 SOLE VOTING POWER
SHARES 6,101,946
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BENEFICIALLY 6 SHARED VOTING POWER
OWNED BY 0
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EACH 7 SOLE DISPOSITIVE POWER
REPORTING 6,101,946
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PERSON 8 SHARED DISPOSITIVE POWER
WITH 0
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
6,578,136
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES* | |
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
9.4%
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12 TYPE OF REPORTING PERSON*
IN
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*SEE INSTRUCTION BEFORE FILLING OUT!
**SEE ITEM 4 OF THIS FILING
CUSIP NO. 714290103 13G/A PAGE 3 OF 7 PAGES
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1 NAME OF REPORTING PERSONS
I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY)
Michael J. Jandernoa Trust
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Michigan
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NUMBER OF 5 SOLE VOTING POWER
SHARES 5,905,513
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BENEFICIALLY 6 SHARED VOTING POWER
OWNED BY 0
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EACH 7 SOLE DISPOSITIVE POWER
REPORTING 5,905,513
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PERSON 8 SHARED DISPOSITIVE POWER
WITH 0
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
5,905,513
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES
CERTAIN SHARES* | |
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
8.4%
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12 TYPE OF REPORTING PERSON*
OO--Trust
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*SEE INSTRUCTION BEFORE FILLING OUT!
**SEE ITEM 4 OF THIS FILING
CUSIP NO. 714290103 13G/A PAGE 4 OF 7 PAGES
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ITEM 1.
(a) Name of Issuer: Perrigo Company
(b) Address of Issuer's Principal Executive Offices: 515 Eastern Avenue
Allegan, Michigan 49010
ITEM 2.
(a)-(c) Name, Principal Business Address and Citizenship of Person Filing:
Michael J. Jandernoa
c/o Law Weathers & Richardson
333 Bridge Street, NW, Suite 800
Grand Rapids, Michigan 49504
Citizenship: United States
(d) Title of Class of Securities: Common Stock, without par value.
(e) CUSIP Number: 714290103
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b), OR
13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A:
(a)-(j) Not Applicable.
ITEM 4. OWNERSHIP
(a) Mr. Jandernoa is the beneficial owner of 6,578,136 shares of the
Issuer's common stock, without par value. Mr. Jandernoa owns 2,986
shares of the Issuer's commons stock. The Michael J. Jandernoa Trust, of
which Mr. Jandernoa is the sole trustee, holds 5,905,513 shares of the
Issuer's common stock. The Michael J. Jandernoa Grantor Trust 2, of
which Mr. Jandernoa is the sole trustee and has a reversionary interest,
holds 182,834 shares of the Issuer's common stock. Mr. Jandernoa holds
sole voting and dispositive power in both the Michael J. Jandernoa Trust
and the Michael J. Jandernoa Grantor Trust 2. The Susan M. Jandernoa
Trust holds 293,356 shares of the Issuer's common stock. Mrs. Jandernoa
is the sole trustee and holds sole voting and dispositive power for the
shares of common stock held by the Susan M. Jandernoa Trust. The Susan
M. Jandernoa Grantor Trust 2 holds 182,834 shares of the Issuer's common
stock. Mrs. Jandernoa is the sole trustee and holds sole voting and
dispositive power for the shares of common stock held by the Susan M.
Jandernoa Grantor Trust 2. Mr. Jandernoa holds stock options that give
him the right to acquire 10,613 shares of the Issuer's common stock
within 60 days of the date of this filing. The figures above are as of
January 31, 2004.
CUSIP NO. 714290103 13G/A PAGE 5 OF 7 PAGES
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(b) As of January 31, 2004, Mr. Jandernoa was the beneficial owner of 9.4%
of the Issuer's outstanding common stock, without par value. The
Issuer's most recent Form 10-Q (for the quarterly period ended December
27, 2003) lists 70,124,170 shares of the Issuer's common stock,
outstanding as of January 23, 2004. In addition, Mr. Jandernoa holds
stock options, which give him the right to acquire 10,613 shares of the
Issuer's common stock within 60 days of the date of this filing. Mr.
Jandernoa's beneficial ownership percentage is based on a total of
70,134,783 shares of the Issuer's common stock, which consists of the
Issuer's outstanding common stock plus shares that would become
outstanding if Mr. Jandernoa exercised his stock options.
As of January 31, 2004, the Michael J. Jandernoa Trust held 8.4% of the
Issuer's outstanding common stock, without par value. The beneficial
ownership percentage of the Michael J. Jandernoa Trust is based on the
Issuer's 70,124,170 shares of common stock outstanding as of January 23,
2004.
(c) (i) Mr. Jandernoa has sole power to vote or direct the vote of
6,101,946 shares of common stock.
(ii) Mr. Jandernoa does not share power to vote or to direct the vote
of any shares of common stock.
(iii) Mr. Jandernoa has sole power to dispose or direct the disposition
of 6,101,946 shares of common stock.
(iv) Mr. Jandernoa does not share power to dispose or to direct the
disposition of any shares of common stock.
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
The Michael J. Jandernoa Trust, of which Mr. Jandernoa is the trustee,
holds 5,905,513 shares of the Issuer's common stock.
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED
THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY
Not Applicable.
CUSIP NO. 714290103 13G/A PAGE 6 OF 7 PAGES
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ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP
Not Applicable.
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.
CUSIP NO. 714290103 13G/A PAGE 7 OF 7 PAGES
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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.
February 10, 2004
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Date
/s/ Michael J. Jandernoa
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Signature
Michael J. Jandernoa
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As trustee of the Michael J. Jandernoa
Trust and in his individual capacity