SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
LAMOTTE ANDRE

(Last) (First) (Middle)
C/O ICAGEN, INC.
4222 EMPEROR BLVD., SUITE 350

(Street)
DURHAM NC 27703

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/03/2005
3. Issuer Name and Ticker or Trading Symbol
ICAGEN INC [ ICGN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 27,175 I By Medical Science Partners, L.P.(1)
Common Stock 19,592 I By Medical Science Partners II, L.P.(1)
Common Stock 19,233 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Series C Convertible Preferred Stock (2) (2) Common Stock 1,305 (3) D
Series D Convertible Preferred Stock (2) (2) Common Stock 12,365 (3) D
Series F Convertible Preferred Stock (2) (2) Common Stock 118 (3) D
Series H Convertible Preferred Stock (2) (2) Common Stock 262 (3) D
Series C Convertible Preferred Stock (2) (2) Common Stock 206,523 (3) I By European Medical Ventures.(1)
Series D Convertible Preferred Stock (2) (2) Common Stock 57,691 (3) I By European Medical Ventures.(1)
Series F Convertible Preferred Stock (2) (2) Common Stock 18,791 (3) I By European Medical Ventures.(1)
Series H Convertible Preferred Stock (2) (2) Common Stock 41,597 (3) I By European Medical Ventures.(1)
Series C Convertible Preferred Stock (2) (2) Common Stock 69,084 (3) I By Medical Science II Co-Investment, L.P.(1)
Series A Convertible Preferred Stock (2) (2) Common Stock 325,000 (3) I By Medical Science Partners, L.P.(1)
Series B Convertible Preferred Stock (2) (2) Common Stock 157,186 (3) I By Medical Science Partners, L.P.(1)
Series C Convertible Preferred Stock (2) (2) Common Stock 291,803 (3) I By Medical Science Partners II, L.P(1)
Stock Option (right to buy) (4) 01/01/2013 Common Stock 10,000 $2.25 D
Stock Option (right to buy) (5) 01/01/2014 Common Stock 25,000 $2.25 D
Explanation of Responses:
1. The reporting person is managing partner of the listed entities. The reporting person disclaims beneficial ownership of the shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.
2. The Series A, Series B, Series C, Series D, Series F and Series H Convertible Preferred Stock is immediately exercisable and does not have an expiration date. Upon the closing of the Issuer's public offering, these shares will automatically convert into common stock of the Issuer.
3. These shares are convertible on a 1-for-1 basis into common stock of the Issuer.
4. Option fully vested one year after the date of grant (12/31/03).
5. Option vests monthly over the three years commencing 01/01/2004.
Remarks:
Exhibit 24
Holly A. Coldiron, Attorney-in-fact 02/02/2005
** 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 5 (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.
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