FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
DECODE GENETICS INC [ DCGN ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 09/15/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 09/15/2003 | X | 189,496 | A | $1 | 772,350 | I | See Footnote(1) | ||
Common Stock | 09/15/2003 | J(2) | 10,528 | D | $18 | 761,822 | I | See Footnote(1) | ||
Common Stock | 09/15/2003 | X | 11,337 | A | $1 | 45,268 | I | See Footnote(3) | ||
Common Stock | 09/15/2003 | J(2) | 630 | D | $18 | 44,638 | I | See Footnote(3) | ||
Common Stock | 70,794 | I | See Footnote(4) |
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 Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrant | $1 | 09/15/2003 | X | 189,496 | 10/30/1997 | 08/25/2005 | Common Stock | 189,496 | $0 | 0 | I | See Footnote(1) | |||
Warrant | $1 | 09/15/2003 | X | 11,337 | 10/30/1997 | 08/25/2005 | Common Stock | 11,337 | $0 | 0 | I | See Footnote(3) |
Explanation of Responses: |
1. The reportable securities are held by Polaris Venture Partners, L.P. The reporting person is a member of Polaris Venture Management Co., L.L.C. which is the general partner of Polaris Venture Partners, L.P. In prior years, the reporting person reported beneficial ownership of an additional 1,000,000 shares of common stock, which were distributed, pro rata, to the partners of Polaris Venture Partners, L.P., in two equal amounts in March 2002 and April 2002. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
2. Payment of exercise price through withholding securities upon exercise of a warrant to purchase common stock.. |
3. The reportable securities are held by Polaris Venture Partners Founders' Fund, L.P. The reporting person is a member of Polaris Venture Management Co., L.L.C. which is the general partner of Polaris Venture Partners Founders' Fund, L.P. In prior years, the reporting person reported beneficial ownership of an additional 58,230 shares of common stock, which were distributed, pro rata, to the partners of Polaris Venture Partners Founders' Fund, L.P., in two equal amounts in March 2002 and April 2002. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
4. The reportable securities are held by Terrance McGuire TTEE, Terrance McGuire Trust-1999. Includes an aggregate of 67,794 shares received as distributions from Polaris Venture Partners, L.P. and Polaris Venture Partners Founders' Fund, L.P., in March 2002 and April 2002. |
/s/ Terrance McGuire | 09/15/2003 | |
** Signature of Reporting Person | Date | |
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). | ||
** 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 is insufficient, see Instruction 6 for procedure. | ||
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 Number. |