-----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, F2+rzXQBJGePVUCE4sexDl+9/2oo7VyeOz3EMfwQnxqcUR2PcexASYCrHGMQmlXf dJ1sB/A3K9EtEABinLJSGQ== 0000922423-00-000365.txt : 20000216 0000922423-00-000365.hdr.sgml : 20000216 ACCESSION NUMBER: 0000922423-00-000365 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000201 FILED AS OF DATE: 20000215 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ATLANTIC PHARMACEUTICALS INC CENTRAL INDEX KEY: 0001001316 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 363898269 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 033-98478 FILM NUMBER: 546197 BUSINESS ADDRESS: STREET 1: 1017 MAIN CAMPUS DRIVE STREET 2: SUITE 3900 CITY: RALEIGH STATE: NC ZIP: 27606 BUSINESS PHONE: 9195137020 MAIL ADDRESS: STREET 1: 1017 MAIN CAMPUS DRIVE STREET 2: SUITE 3900 CITY: RALEIGH STATE: NC ZIP: 27605 COMPANY DATA: COMPANY CONFORMED NAME: ZOTOS FREDERIC P CENTRAL INDEX KEY: 0001076655 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 28 OLD COACH ROAD CITY: COHASSET STATE: MA ZIP: 02025 5 1 FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |_| Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |_| Form 3 Holdings Reported |_| Form 4 Transactions Reported 1. Name and Address of Reporting Person Zotos, Federic P. 2007 Court North Drive Melville, New York 11747 2. Issuer Name and Ticker or Trading Symbol Atlantic Pharmaceuticals, Inc. ("ATLC") 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 02/00 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) President 7. Individual or Joint/Group Reporting (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
- ----------------------------------------------------------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | - -----------------------------------------------------------------------------------------------------------------------------------| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | |Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership | |Date |Code| (Instr.3,4 and 5) | Beneficially |(D)or | (Instr. 4) | | |(Ins| | A/| | Owned at |Indir | | | |tr.8) Amount | D | Price | End of Year |ect(I)| | | | | | | (Instr. 3 and 4) |(Ins | | | | | | | | tr.4)| | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------|
*If form is filed by more than one reporting person, see instruction 4(b)(v). (Over) SEC 2270(7-96) FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ----------------------------------------------------------------------------------------------------------------------------------- Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | - -----------------------------------------------------------------------------------------------------------------------------------| 1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | |(In | red(A) or Dis |Date(Month/| (Instr. 3 and 4 |Secu |Securities |(D)|Ownership | |ice of | |str.| posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva | | 8) | (Instr.3,4 |Date |Expir| |(Instr.|ficially |Ind| | |tive | | | and 5) | A/|Exer-|ation| Title and Number | 5) |Owned at |ire| | |Secu | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity | | | Amount | |ble | | | |Year |(I)| | | | | | | | | | | |(Instr. 4) |(Instr. 4) | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Option |$1.375 |5/28/| A | 10,000 | |5/28/|5/27/|Common |10,000 | | | D | | (right to buy) | | 99 | | | |99(1)| 09 |Stock | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Option |$1.75 |9/23/| A | 2,000 | |9/23/|9/22/|Common | 2,000 | | | D | | (right to buy) | | 99 | | | |99(2)|09 |Stock | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Stock Option |$1.50 |10/21| A | 25,000 | | (3) |10/20|Common |25,000 | | 37,000 | D | | (right to buy) | | 99 | | | | |09 |Stock | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------|
(1) The option vests in three equal annual installments beginning on May 28, 2000. (2) The option vests on September 23, 2000 (3) The option vests immediately but may only be exercised if the fair market value of the Common Stock is equal to or greater than $3.50 per share. Frederic P. Zotos /s/ Frederic P. Zotos February 9, 2000 -------------------------------- ---------------- ** Signature of Reporting Person Date Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2 SEC 2270 (7-96) -----END PRIVACY-ENHANCED MESSAGE-----