-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, A9bBJj0snUkZT3A8eNmqGriDj2jvA96hOooue2t9iZ6oRxjtlj3ktTSu7xTOODK1 vDsRf7EWem1Hz+PEUoLw+g== 0001193125-04-152013.txt : 20040903 0001193125-04-152013.hdr.sgml : 20040903 20040903132726 ACCESSION NUMBER: 0001193125-04-152013 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040903 DATE AS OF CHANGE: 20040903 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Sirgo Mark A CENTRAL INDEX KEY: 0001301715 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: BUSINESS PHONE: 919 510 8542 MAIL ADDRESS: STREET 1: 3100 STONE GAP COURT CITY: RALEIGH STATE: NC ZIP: 27612 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BIODELIVERY SCIENCES INTERNATIONAL INC CENTRAL INDEX KEY: 0001103021 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 352089858 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-57907 FILM NUMBER: 041016190 BUSINESS ADDRESS: STREET 1: 865 LONGBOAT KEY CLUB ROAD CITY: LONGBOAT KEY STATE: FL ZIP: 34228 BUSINESS PHONE: 8124797266 MAIL ADDRESS: STREET 1: 865 LONGBOAT KEY CLUB ROAD CITY: LONGBOAT KEY STATE: FL ZIP: 34228 FORMER COMPANY: FORMER CONFORMED NAME: MAS ACQUISITION XXIII CORP DATE OF NAME CHANGE: 20000111 SC 13G 1 dsc13g.htm MARK SIRGO Mark Sirgo

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

 

SCHEDULE 13G

 

 

Under the Securities Exchange Act of 1934

(Amendment No.         )*

 

 

 

 

 

BIODELIVERY SCIENCES INTERNATIONAL, INC.


(Name of Issuer)

 

 

Series A Non-Voting Convertible Preferred


(Title of Class of Securities)

 

 

09060J106


                                (CUSIP Number)                                

 

 

August 24, 2004


(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)

 

 

*   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 in 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).


CUSIP No. 09060J106

 

  1.  

Names of Reporting Persons.

I.R.S. Identification Nos. of above persons (entities only).

 

 

             Mark A. Sirgo

   
  2.  

Check the Appropriate Box if a Member of a Group (See Instructions)

(a)  ¨

(b)  ¨

   
  3.  

SEC Use Only

 

 

 

   
  4.  

Citizenship or Place of Organization

 

 

             United States

   

 

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

 

 

  5.    Sole Voting Power

 

            797,414

 

  6.    Shared Voting Power

 

            0

 

  7.    Sole Dispositive Power

 

            797,414

 

  8.    Shared Dispositive Power

 

            0

  9.  

Aggregate Amount Beneficially Owned by Each Reporting Person

 

 

            797,414 (Series A Non-Voting Preferred Stock convertible 1:1 for voting
            Common Stock)

   
10.  

Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)

 

            Not Applicable

   
11.  

Percent of Class Represented by Amount in Row (9)

 

 

             10.1%

   
12.  

Type of Reporting Person (See Instructions)

 

 

             IN

   

 


Item 1.

 

(a)

  

Name of Issuer:

        BioDelivery Sciences International, Inc.

         
   

(b)

  

Address of Issuer’s Principal Executive Offices

        185 South Orange Avenue, Admin. Building 4, Newark, New Jersey 07103

         

Item 2.

 

(a)

  

Name of Person Filing:

        Mark A. Sirgo

         
   

(b)

  

Address of Principal Business Office or, if none, Residence:

        3100 Stone Gap Court, Raleigh, North Carolina 27612

         
   

(c)

  

Citizenship:

        United States

         
   

(d)

  

Title of Class of Securities:

        Series A Non-Voting Convertible Preferred Stock

         
   

(e)

  

CUSIP Number:    

        09060J106

         

Item 3.

  Filing Pursuant to Rules 13d-1(b) or 13d-2(b)c), check whether the person filing is a:     
         Not Applicable          

 

Item 4.

   Ownership.           
     (a)    Amount beneficially owned:      797,414                                                                         
     (b)    Percent of class:      10.1%    
     (c)    Number of shares as to which the person has:           
          (i)    Sole power to vote or to direct the vote:      797,414    
          (ii)    Shared power to vote or to direct the vote:      0    
          (iii)    Sole power to dispose or to direct the disposition of:      797,414    
          (iv)    Shared power to dispose or to direct the disposition of:      0    


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.

        Not Applicable

         

Item 7.

  

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person.

        Not Applicable

Item 8.

  

Identification and Classification of Members of the Group.

        Not Applicable

         

Item 9.

  

Notice of Dissolution of Group.

        Not Applicable

         

Item 10.

  

Certification.

        Not Applicable

         

 


After reasonable inquiry and to the best of our knowledge and belief, the undersigned certify that the information set forth in this statement is true, complete and correct.

 

Dated: August 31, 2004

 

    /s/ Jason S. Wood
   

Jason S. Wood, as attorney-in-fact for

Mark A. Sirgo

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