U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
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(f) of the Investment Company Act of 1940
[_] Check box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
VA Partners, LLC
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(Last) (First) (Middle)
One Maritime Plaza, Suite 1400
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(Street)
San Francisco CA 94111
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Mentor Corporation (MNTR)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Day/Year
APRIL 21, 2003
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check applicable line)
[ ] Form filed by one Reporting Person
[X] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) Amount of ship
3. or Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. 2A. Deemed Code ------------------------ Owned Following (D) or Indirect
1. Transaction Execution (Instr. 8) (A) Reported Transaction Indirect Beneficial
Title of Security Date Date, if any ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock 04/21/03 P 2,500 A 17.00 5,911,518(1)(2) I (1)(2)
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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).
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.
(Over)
SEC 1474 (3-00)
PAGE 2 OF 5
FORM 4 (continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative Following In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- Reported direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Transaction (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Explanation of Responses:
(1)As General Partner and Investment Manager of ValueAct Capital Partners, L.P.,
ValueAct Capital Partners II, L.P., and ValueAct Capital International, Ltd.
(2)These securities are also beneficially owned by Jeffrey W. Ubben, George F.
Hamel, Jr., and Peter H. Kamin as Managing Members, Principal Owners and
Controlling Persons of VA Partners, LLC.
VALUEACT CAPITAL PARTNERS, L.P., BY
VA PARTNERS, L.L.C., ITS GENERAL PARTNER
By: /s/ George F. Hamel, Jr. 04/23/03
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George F. Hamel, Jr. Date
Managing Member
**Signature of Reporting Person
VALUEACT CAPITAL PARTNERS II, L.P., BY
VA PARTNERS, L.L.C., ITS GENERAL PARTNER
By: /s/ George F. Hamel, Jr. 04/23/03
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George F. Hamel, Jr. Date
Managing Member
**Signature of Reporting Person
VALUEACT CAPITAL INTERNATIONAL, LTD., BY
VA PARTNERS, L.L.C., ITS INVESTMENT MANAGER
By: /s/ George F. Hamel, Jr. 04/23/03
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George F. Hamel, Jr. Date
Managing Member
**Signature of Reporting Person
PAGE 3 OF 5
VA PARTNERS, L.L.C.
By: /s/ George F. Hamel, Jr. 04/23/03
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George F. Hamel, Jr. Date
Managing Member
**Signature of Reporting Person
By: /s/ Jeffrey W. Ubben 04/23/03
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Jeffrey W. Ubben Date
**Signature of Reporting Person
By: /s/ George F. Hamel, Jr. 04/23/03
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George F. Hamel, Jr. Date
**Signature of Reporting Person
By: /s/ Peter H. Kamin 04/23/03
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Peter H. Kamin Date
**Signature of Reporting Person
** 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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Joint Filer Information
Name: ValueAct Capital Partners, L.P.
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
Name: ValueAct Capital Partners II, L.P.
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
Name: ValueAct Capital International, Ltd.
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
Name: Jeffrey W. Ubben
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
Name: George F. Hamel, Jr.
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
Name: Peter H. Kamin
Address: One Maritime Plaza, Suite 1400, San Francisco, CA 94111
Designated Filer: VA Partners, L.L.C.
Issuer and Ticker Symbol: Mentor Corporation (MNTR)
Date of Event Requiring Statement: April 21, 2003
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