SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 8-K CURRENT REPORT Pursuant to Section 13 or 15(d) of the Securities Exchange Act December 1, 2003 ---------------- Date of Report (Date of Earliest Event Reported) OMNI MEDICAL HOLDINGS, INC. --------------------------- (Exact Name of Registrant as Specified in its Charter) Utah 0-26177 87-0425275 ---- ------- ---------- (State or other (Commission File No.) (IRS Employer I.D. No.) Jurisdiction) 1107 Mt. Rushmore Road, Suite 2 Rapid City, South Dakota 57701 ------------------------------- (Address of Principal Executive Offices) (605) 718-0380 -------------- Registrant's Telephone Number Not Applicable -------------- (Former Name or Former Address if changed Since Last Report) Item 2. Acquisition or Disposition of Assets. On November 23, 2003, Omni Medical Holdings, Inc. (the "Company") signed an Asset Purchase Agreement, which was deemed to have been completed as of December 1, 2003, by and between McCoy Business Services, Inc., a Kentucky corporation ("McCoy"), and the Company, and whereby the Company purchased all of McCoy's tangible assets related to medical transcription services provided by McCoy and assumed McCoy's lease for its principal office space. The consideration for this transaction was $360,000,with $120,000 having been paid at closing and $240,000 to be paid in eight quarterly payments of $30,000 each, with an earnout provision, which is described fully in the Asset Purchase Agreement. The purchase price was allocated $60,000 for equipment, furniture and other depreciable assets; $240,000 for a related Covenant Not to Compete of Marlene McCoy, McCoy's principal stockholder and director and executive officer, who was also given a two year Employment Agreement; and $60,000 as goodwill. A complete list of the equipment acquired and the Employment Agreement are respectively Exhibits A and C to the Asset Purchase Agreement. The consideration paid was negotiated "arms length," and the directors of the Company determined that the consideration for the purchase was reasonable, under these circumstances. No director, executive officer or five percent or more stockholder of the Company had any direct or indirect interest in McCoy prior to the completion of the Asset Purchase Agreement. For more information regarding this transaction, see the Asset Purchase Agreement and related Exhibits attached hereto and incorporated herein by reference. See Item 7 of this Current Report. Item 7. Financial Statements, Pro Forma Financial Information and Exhibits. --------- (a) Financial Statements of Businesses Acquired. McCoy Business Services for the years ended December 31, 2002 and 2001, and the period ended September 30, 2003 Financial Statements MCCOY BUSINESS SERVICES Years ended December 31, 2002 and 2001 and period ended September 30, 2003 (Unaudited) MCCOY BUSINESS SERVICES Table of Contents Independent Auditor's Report 1 Financial Statements Balance Sheets as of December 31, 2002 and 2001 2 Statements of Operations for the years ended December 31, 2002 and 2001 3 Statements of Changes in Stockholder's Equity for the years ended December 31, 2002 and 2001 4 Statements of Cash Flows for the years ended December 31, 2002 and 2001 5 Notes to Financial Statements 6 Interim Financial Statements (Unaudited) Independent Auditor's Report on Supplementary Information 10 Balance Sheets as of September 30, 2003 (Unaudited) and December 31, 2002 11 Statements of Operations for the nine months ended September 30, 2003 and 2002 (Unaudited) 12 Statements of Cash Flows for the nine months ended September 30, 2003 and 2002 (Unaudited) 13 Notes to Interim Financial Statements (Unaudited) 14 Carpenter, Mountjoy & Bressler [letterhead] INDEPENDENT AUDITOR'S REPORT To the Stockholder of McCoy Business Services Louisville, Kentucky We have audited the accompanying balance sheets of McCoy Business Services, a division of McCoy's Business Services, Inc., (see Note A) as of December 31, 2002 and 2001, and the related statements of operations, changes in stockholder's equity, and cash flows for the years then ended. These financial statements are the responsibility of McCoy Business Services' management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of McCoy Business Services as of December 31, 2002 and 2001, and the results of its operations and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. /S/Carpenter, Mountjoy & Bressler Louisville, Kentucky January 15, 2003 MCCOY BUSINESS SERVICES BALANCE SHEETS December 31 2002 2001 ASSETS Current Assets Cash and equivalents $ 81,819 $ 125,167 Accounts receivable 88,982 63,154 --------- --------- Total current assets 170,801 188,321 Property, Plant & Equipment Office furniture and fixtures 11,268 11,268 Medical equipment 60,100 44,677 --------- --------- 71,368 55,945 Less accumulated depreciation 17,002 7,775 --------- --------- 54,366 48,170 --------- --------- $ 225,167 $ 236,491 ========= ========= LIABILITIES AND STOCKHOLDER'S EQUITY Liabilities Accounts payable $ 19,775 $ 14,222 Deferred income taxes 25,020 18,921 Accrued expenses 24,645 12,966 Due to related party 5,888 48,359 --------- --------- Total current liabilities 75,328 94,468 --------- --------- Deferred Income Taxes 8,233 4,971 Stockholder's Equity Common stock, no par value, 2,000 shares authorized, 100 shares issued and outstanding 100 100 Retained earnings 141,506 136,952 --------- --------- 141,606 137,052 --------- --------- $ 225,167 $ 236,491 ========= ========= See accompanying independent auditor's report and notes to financial statements 2 MCCOY BUSINESS SERVICES STATEMENTS OF OPERATIONS Year ended December 31 2002 2001 Revenue $ 675,194 $ 551,237 Expenses Contract transcription 345,399 284,948 Salaries and wages 147,193 128,726 Employee benefits 25,090 21,838 Auto reimbursement and courier 21,835 10,903 Taxes 13,214 14,486 Bad debt expense - 58,691 Other general and administrative 110,952 52,572 --------- --------- Total expenses 663,683 572,164 --------- --------- Income (loss) from operations 11,511 (20,927) Other income (expense) 308 (11,594) --------- --------- Income (loss) before income taxes 11,819 (32,521) Income tax expense (benefit) 7,265 (4,209) --------- --------- Net Income (Loss) $ 4,554 $ (28,312) ========= ========= See accompanying independent auditor's report and notes to financial statements 3 MCCOY BUSINESS SERVICES STATEMENTS OF CHANGES IN STOCKHOLDER'S EQUITY Years ended December 31, 2002 and 2001 Common Retained Stock Earnings Total Balance, January 1, 2001 $ 100 $ 165,264 $ 165,364 Net loss - (28,312) (28,312) ----- --------- --------- Balance, December 31, 2001 100 136,952 137,052 Net income - 4,554 4,554 ----- --------- --------- Balance, December 31, 2002 $ 100 $ 141,506 $ 141,606 ===== ========= ========= See accompanying independent auditor's report and notes to financial statements 4 MCCOY BUSINESS SERVICES STATEMENTS OF CASH FLOWS Year ended December 31 2002 2001 Cash Flows From Operating Activities Net income (loss) $ 4,554 $ (28,312) Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities: Depreciation 9,227 7,775 Deferred income taxes 9,361 4,430 Loss on sale of investments - 15,512 Change in operating assets and liabilities: Accounts receivable (25,828) (4,830) Accounts payable 5,553 8,340 Accrued expenses 11,679 (22,465) -------- --------- Total adjustments 9,992 8,762 -------- --------- Net cash provided by (used in) operating activities 14,546 (19,550) Cash Flows From Investing Activities Purchase of fixed assets (15,423) (31,890) Proceeds from sale of investments - 45,673 -------- --------- Net cash provided by (used in) investing activities (15,423) 13,783 Cash Flows From Financing Activities Net activity from related party (42,471) 57,960 -------- --------- Net cash provided by (used in) financing activities (42,471) 57,960 -------- --------- Net Increase (Decrease) in Cash (43,348) 52,193 Cash, Beginning of Year 125,167 72,974 -------- --------- Cash, End of Year $ 81,819 $ 125,167 ======== ========= See accompanying independent auditor's report and notes to financial statements 5 MCCOY BUSINESS SERVICES NOTES TO FINANCIAL STATEMENTS December 31, 2002 and 2001 NOTE A--DESCRIPTION OF BUSINESS AND BASIS OF PRESENTATION Business: McCoy's Business Services, Inc. (the Company) is located in Louisville, Kentucky and primarily operates two divisions. (Effective December 10, 2003, the Company changed its name to McCoy Financial Services, Inc.) McCoy Business Services (McCoy Business) provides medical transcription services to medical practitioners. McCoy Financial Services (McCoy Financial) provides a wide range of financial services primarily focused at individual customers. Basis of Presentation: In 2003, the tangible assets of McCoy Business were acquired by Omni Medical Services, Inc. (Omni) (See Note G). Accordingly, the financial statements presented are for the McCoy Business division only. Effective January 1, 2002, the Company began to separately account for the two operating divisions. Accordingly, no allocation of accounts was necessary in 2002. Prior to this time, the Company had not separately accounted for these two divisions. Therefore, management has specifically identified accounts directly related to McCoy Business for purposes of these financial statements. Overhead expenses were shared by the two divisions and have been allocated evenly between the divisions, which is management's best estimate. The Company also had a coffee shop operation during 2001, which was accounted for separately. Therefore, it is not included in these financial statements. NOTE B--BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Estimates: Management uses estimates and assumptions in preparing these financial statements in accordance with accounting principles generally accepted in the United States of America. Those estimates and assumptions affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities, and the reported revenues and expenses. Actual results could vary from the estimates that were used. Accounts Receivable: McCoy Business grants credit to its customers, generally without collateral. McCoy Business considers accounts receivable to be fully collectible; accordingly, no allowance for doubtful accounts is required. If amounts become uncollectible, they will be charged to operations when that determination is made. Property and Equipment: Property and equipment are carried at cost and are being depreciated on a straight-line basis over the estimated useful lives of the assets, which range from 5 to 7 years. Statement of Cash Flows: For purposes of the statement of cash flows, McCoy Business considers all short-term investments with a maturity of three months or less to be cash equivalents. Cash paid by the Company as a whole for taxes was $3,680 and $6,737 for the years ended December 31, 2002 and 2001, respectively. Concentration of Credit Risk: McCoy Business maintains cash balances at a local bank. The cash account is insured by FDIC up to $100,000. Cash balances did not exceed insured limits in both years ended December 31, 2002 and 2001. Revenue Recognition: Revenue is recognized at the time when the services are performed. Continued 6 MCCOY BUSINESS SERVICES NOTES TO FINANCIAL STATEMENTS--CONTINUED December 31, 2002 and 2001 NOTE B--BASIS OF PRESENTATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES-- CONTINUED Advertising Costs: McCoy Business expenses advertising as incurred. Advertising expense was $2,798 and $3,616 for the years ended December 31, 2002 and 2001, respectively. Income Taxes: Deferred taxes are provided for temporary differences in reporting certain transactions for financial and tax purposes, principally relating to differences in accounting for transactions on the accrual basis versus the cash basis and depreciation of fixed assets. NOTE C--INCOME TAXES As previously discussed, McCoy Business is a division of the Company. Therefore, their results of operations combined with the total Company operations determine the tax position of the Company as a whole. For purposes of these financial statements, the tax provision for McCoy Business has been calculated on a stand alone basis. Significant components of McCoy Business' net deferred tax assets (liability) as of December 31 are as follows: 2002 2001 Deferred tax assets (liabilities): Tax over book depreciation $ (8,233) $ (4,971) Cash to accrual (cash basis taxpayer) (25,020) (18,921) -------- --------- Net deferred tax assets (liabilities) $(33,253) $ (23,892) ======== ========= The significant components of income tax expense (benefit) are as follows: Current: Federal $ (1,640) $ (6,876) State (456) (1,763) Deferred 9,361 4,430 -------- --------- $ 7,265 $ (4,209) ======== ========= NOTE D--COMMITMENTS McCoy Business leases its operating facility under an operating lease agreement. Total rental expense was approximately $22,800 and $8,100 for the years ended December 31, 2002 and 2001, respectively. McCoy Business is responsible for real estate taxes, insurance, utilities and maintenance of the property. The lease was personally guaranteed by the stockholder. As part of the asset purchase agreement (see Note G), the lease obligation was assumed by Omni Medical Services, Inc. Continued 7 MCCOY BUSINESS SERVICES NOTES TO FINANCIAL STATEMENTS--CONTINUED December 31, 2002 and 2001 NOTE D--COMMITMENTS--CONTINUED Future minimum rental payments under the lease as of December 31, 2002 are as follows: 2003 $ 22,517 2004 22,517 2005 22,517 ---------- $ 67,551 ========== NOTE--RELATED PARTY The due to/from related party relates primarily to amounts resulting from the allocation of expenses between McCoy Business and McCoy Financial. As discussed in Note A, the Company had a previous coffee shop operation. McCoy Business had advanced funds to this operation. During 2001, the coffee shop was sold and the outstanding advances due to McCoy Business of $58,691 were deemed uncollectible and charged to bad debt expense. NOTE F--RETIREMENT PLAN The Company has a defined contribution retirement plan that covers substantially all employees, including those of McCoy Business. The plan also contains a deferred-salary arrangement under a Simple IRA. Under the deferred-salary arrangement, employees can contribute up to $7,000 for 2002 and $6,500 for 2001. Company may match up to the first 3% of the gross pay. All contributions are required per the plan adopted by the employer under IRS 5304-Simple. Contributions paid to the plans and charged to operations amounted to $1,378 for 2002 and $1,997 for 2001. NOTE G--SUBSEQUENT EVENT Effective December 1, 2003, McCoy Business was acquired in an asset purchase agreement by Omni Medical Services, Inc., (Omni) a corporation based in South Dakota. Omni agreed to purchase the tangible assets related to and used in the operation of the business related to medical transcription services, and all existing contracts and proposals with all of McCoy Business' medical transcription clients. In connection with the agreement, a covenant not to compete for a period of two years and a twenty-four month employment agreement to assist in the transition of the business were both entered with the owner of McCoy Business. The total purchase price under the agreement was $360,000. The purchase price of the acquisition has been allocated based on the fair value of all identifiable assets at the date of acquisition. The purchase price exceeded the fair value of the identifiable assets by $60,000. Continued 8 MCCOY BUSINESS SERVICES NOTES TO FINANCIAL STATEMENTS--CONTINUED December 31, 2002 and 2001 NOTE--SUBSEQUENT EVENT--CONTINUED The purchase price allocation for this acquisition was as follows: Equipment, furniture and other depreciable assets $ 60,000 Non-competition agreement 240,000 Goodwill 60,000 ------------ $ 360,000 ============ The acquisition was for $120,000 in cash with the remaining balance of $240,000 to be paid in eight quarterly installments of $30,000 subject to certain earn-out provisions. 9 INTERIM FINANCIAL STATEMENTS (UNAUDITED) Carpenter, Mountjoy & Bressler [letterhead] INDEPENDENT AUDITOR'S REPORT ON ADDITIONAL INFORMATION To the Stockholder of McCoy Business Services Louisville, Kentucky Our report on our audit of the basic financial statements of McCoy Business Services, a division of McCoy's Business Services, Inc. for 2002 and 2001 appears on page 1. That audit was conducted for the purpose of forming an opinion on the basic financial statements taken as a whole. The balance sheet as of September 30, 2003, the statements of operations and cash flows for the periods ended September 30, 2003 and 2002 and the applicable footnotes for these statements on pages 11 through 15 are presented for purposes of additional analysis and are not a required part of the basic financial statements. Such information has not been subjected to the auditing procedures applied in the audit of the basic financial statements and, accordingly, we express no opinion on them. /s/Carpenter, Mountjoy & Bressler Louisville, Kentucky January 15, 2003 MCCOY BUSINESS SERVICES BALANCE SHEETS September 30 December 31 2003 2002 ASSETS (Unaudited) Current Assets Cash and equivalents $ 45,253 $ 81,819 Accounts receivable 79,303 88,982 Prepaid expenses 4,577 - Due from related party 7,374 - ----------- ---------- Total current assets 136,507 170,801 Property, Plant & Equipment Office furniture and fixtures 11,268 11,268 Medical equipment 90,031 60,100 ----------- ---------- 101,299 71,368 Less accumulated depreciation 25,383 17,002 ----------- ---------- 75,916 54,366 ----------- ---------- $ 212,423 $ 225,167 =========== ========== LIABILITIES AND STOCKHOLDER'S EQUITY Current Liabilities Accounts payable $ 37,398 $ 19,775 Deferred income taxes 22,799 25,020 Accrued expenses 5,039 24,645 Due to related party - 5,888 ----------- ---------- Total current liabilities 65,236 75,328 ----------- ---------- Deferred Income Taxes 8,934 8,233 Stockholder's Equity Common stock, no par value, 2,000 shares authorized, 100 shares issued and outstanding 100 100 Retained earnings 138,153 141,506 ----------- ---------- 138,253 141,606 ----------- ---------- $ 212,423 $ 225,167 =========== ========== See accompanying notes to interim financial statements (unaudited) 11 MCCOY BUSINESS SERVICES STATEMENTS OF OPERATIONS (Unaudited) Nine months ended September 30 2003 2002 Revenue $ 476,095 $ 514,507 Expenses Contract transcription 250,811 266,929 Salaries and wages 118,437 108,929 Employee benefits 18,963 20,085 Auto reimbursement and courier 14,266 16,485 Taxes 9,942 9,015 Other general and administrative 68,839 87,941 -------- ---------- Total expenses 481,258 509,384 -------- ---------- Income (loss) from operations (5,163) 5,123 Other income (expense) 77 255 -------- ---------- Income (loss) before income taxes (5,086) 5,378 Income tax expense (benefit) (1,733) 11,397 -------- ---------- Net Loss $ (3,353) $ (6,019) ======== ========== See accompanying notes to interim financial statements (unaudited) 12 MCCOY BUSINESS SERVICES STATEMENTS OF CASH FLOWS (Unaudited) Nine months ended September 30 2003 2002 Cash Flows From Operating Activities Net loss $ (3,353) $ (6,019) Adjustments to reconcile net loss to net cash provided by (used in) operating activities: Depreciation 8,381 6,678 Deferred income tax (1,520) 19,941 Change in operating assets and liabilities: Accounts receivable 9,679 (53,653) Accounts payable 17,623 6,398 Prepaid expenses (4,577) - Accrued expenses (19,606) (9,224) -------- -------- Total adjustments 9,980 (29,860) -------- -------- Net cash provided by (used in) operating activities 6,627 (35,879) Cash Flows From Investing Activities Purchase of fixed assets (29,931) (15,423) -------- -------- Net cash used in investing activities (29,931) (15,423) Cash Flows From Financing Activities Net activity from related party (13,262) (17,996) -------- -------- Net cash used in investing activities (13,262) (17,996) -------- -------- Net Decrease in Cash (36,566) (69,298) Cash, Beginning of Year 81,819 125,167 -------- -------- Cash, End of Year $ 45,253 $ 55,869 ======== ======== See accompanying notes to interim financial statements (unaudited) 13 MCCOY BUSINESS SERVICES NOTES TO INTERIM FINANCIAL STATEMENTS (UNAUDITED) September 30, 2003 NOTE A--DESCRIPTION OF BUSINESS AND BASIS OF PRESENTATION Business: McCoy's Business Services, Inc. is located in Louisville, Kentucky and primarily operates two divisions. (Effective December 10, 2003, the Company changed its name to McCoy Financial Services, Inc.) McCoy Business Services (McCoy Business) provides medical transcription services to medical practitioners. McCoy Financial Services (McCoy Financial) provides a wide range of financial services primarily focused at individual customers. Basis of Presentation: The accompanying unaudited condensed financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America for interim financial information. Accordingly, they do not include all of the information and footnotes required by accounting principles generally accepted in the United States of America for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. McCoy Business Services' business is generally not subject to seasonal variations. Operating results for the nine-month period ended September 30, 2003, are not necessarily indicative of the results that may be expected for the year ended December 31, 2003. In 2003, the tangible assets of McCoy Business were acquired by Omni Medical Services, Inc. (Omni) (See Note B). Accordingly, the financial statements presented are for the McCoy Business division only. Effective January 1, 2002, the Company began to separately account for the two operating divisions. Accordingly, no allocation of accounts was necessary in the preparation of the interim financial statements. For further information, refer to the financial statements and footnotes thereto for the year ended December 31, 2002, included on pages 2-9. NOTE B--SUBSEQUENT EVENT Effective December 1, 2003, McCoy Business was acquired in an asset purchase agreement by Omni Medical Services, Inc., (Omni) a corporation based in South Dakota. Omni agreed to purchase the tangible assets related to and used in the operation of the business related to medical transcription services, and all existing contracts and proposals with all of McCoy Business' medical transcription clients. In connection with the agreement, a covenant not to compete for a period of two years and a twenty-four month employment agreement to assist in the transition of the business were both entered with the owner of McCoy Business. The total purchase price under the agreement was $360,000. The purchase price of the acquisition has been allocated based on the fair value of all identifiable assets at the date of acquisition. The purchase price exceeded the fair value of the identifiable assets by $60,000. Continued 14 MCCOY BUSINESS SERVICES NOTES TO INTERIM FINANCIAL STATEMENTS (UNAUDITED)--CONTINUED NOTE B--SUBSEQUENT EVENT--CONTINUED The purchase price allocation for this acquisition was as follows: Equipment, furniture and other depreciable assets $ 60,000 Non-competition agreement 240,000 Goodwill 60,000 -------- $360,000 ======== The acquisition was for $120,000 in cash with the remaining balance of $240,000 to be paid in eight quarterly installments of $30,000 subject to certain earn-out provisions. 15 (b) Pro Forma Financial Information. OMNI MEDICAL HOLDINGS, INC. UNAUDITED PRO FORMA CONSOLIDATED FINANCIAL STATEMENTS Effective December 1, 2003, Omni Medical Holdings, Inc. ("OMH"), through its wholly-owned subsidiary, Omni Medical Services, Inc., ("OMS"), completed an asset purchase agreement with McCoy Business Services, Inc. ("McCoy"), a corporation based in the state of Kentucky and a provider of medical transcription services. The aggregate purchase price was $360,000 including $120,000 payable at closing, and $240,000 payable in eight equal quarterly installments beginning on February 29, 2004. The $240,000 quarterly payments are subject to an earn-out provision to be calculated based on the amount by which revenues for each quarter are greater or less than a baseline amount. The accompanying unaudited pro forma consolidated statements of operations for the year ended March 31, 2003 and the six months ended September 30, 2003, give effect to the asset purchase agreement as if it had been consummated on April 1, 2002. The unaudited pro forma consolidated statements of operations do not purport to be indicative of the results of operation that actually would have occurred had the transactions been consummated on April 1, 2002 or 2003, or to project the Company's financial operations to any future period. The accompanying unaudited pro forma consolidated balance sheet as of September 30, 2003 gives effect to the asset purchase agreement as of that date. The unaudited pro forma consolidated financial statements should be read in conjunction with the historical financial statements of the Company, as well as those of McCoy Business Services, Inc. OMNI MEDICAL HOLDINGS INC. AND SUBSIDIARIES UNAUDITED PRO FORMA CONSOLIDATED BALANCE SHEET SEPTEMBER 30, 2003 Historical Pro Forma Omni Medical Adjustments Holdings, Inc. (See Note 2) Pro Forma -------------- ------------ --------- Assets Current assets: Cash $ 27,912 $ (27,912)A $ 0 Accounts Receivable 230,215 230,215 Prepaid assets 6,654 0 6,654 ---------- ---------- -------- Total current assets 264,781 (27,912) 236,869 Property and equipment, net 214,695 76,243 A 290,938 Deferred financing costs 25,000 25,000 Goodwill 36,000 36,000 Intangible assets 314,114 300,000 A 614,114 ---------- ---------- -------- Total assets $ 854,590 $ 348,331 $1,202,921 ========== ========== ========== Liabilities and shareholders' equity Current liabilities: Accounts payable $ 85,837 $ $ 85,837 Accrued expenses 36,446 92,088 A 128,534 Notes payable, current portion 473,991 128,122 A 602,113 ---------- ----------- ---------- Total current liabilities 596,274 220,210 816,484 Note payable, net of current portion 147,228 128,121 A 275,349 ---------- ----------- ---------- Total liabilities 743,502 348,331 1,091,833 ---------- ----------- ---------- Minority Interest 20,482 - 20,482 Shareholders' equity: Common stock 10,761 10,761 Common stock to be issued 4,147 4,147 Additional paid-in capital 1,629,005 1,629,005 Deferred compensation expense (35,105) (35,105) Accumulated deficit (1,518,202) (1,518,202) ----------- ----------- ---------- Total shareholders' equity 90,606 - 90,606 ----------- ----------- ---------- Total liabilities and shareholders' equity $ 854,590 $ 348,331 $1,202,921 =========== =========== ========== See the accompanying notes to the unaudited pro forma financial statements. OMNI MEDICAL HOLDINGS INC. AND SUBSIDIARIES UNAUDITED PRO FORMA CONSOLIDATED STATEMENT OF OPERATIONS FOR THE YEAR ENDED MARCH 31, 2003 Historical Pro Forma Omni Medical McCoy Business Adjustments Consolidated Holdings, Inc. Services, Inc. (See Note 2) Pro Forma -------------- -------------- ----------- ----------- Revenues $ 96,462 $ 675,194 $ $ 771,656 Cost of sales 0 477,873 477,873 --------- --------- ---------- ----------- Gross profit 96,462 197,321 0 293,783 General and administrative expenses 230,031 185,810 90,000 B 505,841 --------- ---------- ---------- ----------- Loss from operations (133,569) 11,511 (90,000) (212,058) Other income (expense): Interest income 28,627 308 28,935 Interest expense (11,879) - (12,000)C (23,879) --------- ---------- ---------- ----------- 16,748 308 (12,000) 5,056 Net loss continuing operations (116,821) 11,819 (102,000) (207,002) Loss from discontinued operations (386,361) 0 (386,361) --------- ---------- ---------- ----------- Net loss $(503,182) $ 11,819 $ (102,000) $ (593,363) ========= ========== ========== =========== Loss per share basic and diluted: Continuing operations $ (0.01) $ - $ (0.01) Discontinued operations (0.02) (0.02) --------- ---------- ----------- $ (0.03) $ - $ (0.03) Weighted average number of common shares outstanding 19,730,921 See the accompanying notes to the unaudited pro forma financial statements OMNI MEDICAL HOLDINGS INC. AND SUBSIDIARIES UNAUDITED PRO FORMA CONSOLIDATED STATEMENT OF OPERATIONS FOR THE SIX MONTHS ENDED SEPTEMBER 30, 2003 Historical Pro Forma Omni Medical McCoy Business Adjustments Consolidated Holdings, Inc. Services, Inc. (See Note 2) Pro Forma -------------- -------------- ----------- ----------- Revenues $ 379,839 $ 317,397 $ $ 697,236 Cost of sales 204,474 238,269 442,744 --------- --------- ---------- ----------- Gross profit 175,365 79,127 - 254,492 General and administrative expenses 312,949 82,569 45,000 B 440,519 --------- --------- ---------- ----------- Loss from operations (137,584) (3,442) (45,000) (186,026) Other income (expense): Interest income 260 51 311 Interest expense (17,978) 0 (6,000)C (23,978) --------- --------- ---------- ----------- (17,718) 51 (6,000) (23,667) Minority interest 3,402 0 3,402 Net loss continuing operations (151,900) (3,391) (51,000) (206,291) Loss from discontinued operations (33,736) 0 (33,736) --------- ---------- ---------- ----------- Net loss $(185,636) $ (3,391) $ (51,000) $ (240,027) ========= ========== ========== =========== Loss per share basic and diluted: Continuing operations $ (0.01) $ - $ (0.01) Discontinued operations - - - --------- ---------- ----------- $ (0.01) $ $ (0.01) ========= ========== =========== Weighted average number of common shares outstanding 14,420,323 See the accompanying notes to the unaudited pro forma financial statements OMNI MEDICAL HOLDINS, INC. NOTES TO UNAUDITED PRO FORMA CONSOLIDATED FINANCIAL STATEMENTS 1. Description of the transaction: Effective December 1, 2003, Omni Medical Holdings, Inc. ("OMH"), through its wholly-owned subsidiary, Omni Medical Services, Inc., ("OMS"), completed an asset purchase agreement with McCoy Business Services, Inc. ("McCoy"), a corporation based in the state of Kentucky and a provider of medical transcription services. The aggregate purchase price was $360,000 including $120,000 payable at closing, and $240,000 payable in eight equal quarterly installments beginning on February 29, 2004. The $240,000 quarterly payments are subject to an earn-out provision to be calculated based on the amount by which revenues for each quarter are greater or less than a baseline amount. The estimated fair values of the assets acquired as of December 1, 2003 are as follows: furniture and equipment, $60,000, intangible assets covenant not to compete, customer list and trade name, $2400,000. A supplemental agreement was signed concurrent with the asset purchase agreement, whereby OMS agreed to purchase additional assets that were not included in the original agreement for $16,243.35, payable in eight quarterly installments beginning February 29, 2004. 2. Description of the pro forma adjustments: (a) To record OMS' purchase of the tangible and intangible assets from McCoy and the associated debt (b) To record the amortization of the intangible assets acquired from the McCoy purchase over the estimated useful lives of the assets (c) To record the interest expense incurred due to the debt obligation of the McCoy purchase 3. Discontinued operations: The historical information presented for Omni Medical Holdings, Inc. for the year ended March 31, 2003 has been retroactively restated to reflect the May 1, 2003 disposition of a wholly-owned subsidiary as discontinued operations. 4. Difference in periods presented: The Company's fiscal yearend is March 31. McCoy's fiscal yearend prior to the acquisition was December 31. For purposes of the proforma financial statements, McCoy's historical operating results for the year ended March 31, 2003 represent McCoy's operating results for the year ended December 31, 2002. 5. Income taxes McCoy's results of operations for the year ended December 31, 2002 included income tax expense. The proforma financial statements do not reflect the income tax expense due to the net operating losses generated from Omni Medical Holdings, Inc. as of March 31, 2003. (c) Exhibits. Exhibit Number Description ------ ----------- 10.1 Asset Purchase Agreement Exhibit A-Asset List Exhibit B-Customer List Exhibit C-Employment Agreement 10.2 Promissory Note Security Agreement Bill of Sale and Assumption Agreement Covenant Not to Compete SIGNATURES Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Current Report to be signed on its behalf by the undersigned hereunto duly authorized. OMNI MEDICAL HOLDINGS, INC. Date: 3/1/04 By /s/ Arthur D. Lyons ------ ------------------------ Arthur D. Lyons Director and President