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FORM 4
------ U.S. SECURITIES AND EXCHANGE COMMISSION
[ ] Check box if no longer WASHINGTON, DC 20549
subject to Section 16. Form
4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
continue. See Instruction 1(b).
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 Reporting Person(1)|2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person
| | to Issuer (Check all applicable)
Black Paul M. | Cerner Corporation (CERN) | Director 10% Owner
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(Last) (First) (Middle) |3. IRS Identification | 4. Statement for | X Officer (give title below)
| Number of | Month/Year | -----
| Reporting Person, | | Other (specify below)
| if an Entity | | -----
2800 Rockcreek Parkway | (Voluntary) | September 2001 | Chief Sales Officer & Exec VP
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(Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing
| | Date of Original | (Check applicable line)
| | (Month/Year) | X Form Filed by One Reporting Person
Kansas City, MO 64117-2551 | | | --
-----------------------------------------|-------------------------------------------------| Form Filed by More than One
(City) (State) (Zip) | | -- Reporting Person
| |
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TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security |2. Transaction| 3. Transaction|4. Securities Acquired (A)| 5. Amount of|6. Owner- |7. Nature
(Instr. 3) | Date | Code | or Disposed of (D) | Securities | ship | of
| | (Instr. 8) | (Instr. 3, 4 and 5) | Beneficially| Form: | Indirect
| | | | Owned at End| Direct | Bene-
| |---------------|--------------------------| of Month | (D) or | ficial
| | | | | (A) | | (Instr. 3 | Indirect | Owner-
| (Month/Day/ | | | | or | | and 4) | (I) | ship
| Year) | Code | V | Amount | (D) | Price | |(Instr. 4)|(Instr. 4)
--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
Common Stock | 09/21/01 | M | | 2,500 | A |$13.312500| 16,144 | D |
--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
Common Stock | | | | | | | 328 | I | by Trust
--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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--------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
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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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1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of |6. Date Exer- |7. Title and Amount |8. Price
Security | sion or | action | action | Derivative | cisable and | of Underlying | of
(Instr. 3) | Exercise | Date | Code | Securities Ac- | Expiration | Securities | Deriv-
| Price of | (Month/ | (Instr. 8)| quired (A) or | Date | (Instr. 3 and 4) | ative
| Deriv- | Day/ | | Disposed of (D)| (Month/Day/ | | Secur-
| ative | Year) | | (Instr. 3, 4, | Year) | | ity
| Security | | | and 5) | | | (Instr. 5)
| | | | |-------------------------------------|
| | | | |Date |Expira- | | Amount or |
| | |-------------------------------|Exer- |tion | Title | Number of |
| | | Code |V | (A) |(D) |cisable|Date | | Shares |
------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
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9. Number of | 10. Ownership | 11. Nature of
Derivative | Form of | Indirect
Securities | Derivative | Beneficial
Beneficially | Security: | Ownership
Owned at End | Direct (D) | (Instr. 4)
of Month | or Indirect (I) |
(Instr. 4) | (Instr. 4) |
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Explanation of Responses:
/s/ Paul M. Black 10/10/01
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Signature of Reporting Person(1) Date
(1) 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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(Print or Type Responses)