-----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, BkPJJ1rnxhnfWBTpNQe3Wu7F3ZHUI8OqS76+f5oI3jiwXr0nI9Z7zLCQnFhOLGWr NqA8qAeDJ/HF0oMAzWe66g== 0001209191-04-040712.txt : 20040813 0001209191-04-040712.hdr.sgml : 20040813 20040813120209 ACCESSION NUMBER: 0001209191-04-040712 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040812 FILED AS OF DATE: 20040813 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLEMENS PETER A CENTRAL INDEX KEY: 0001056695 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10113 FILM NUMBER: 04972621 BUSINESS ADDRESS: STREET 1: C/O HALSEY DRUG CO INC STREET 2: 1827 PACIFIC STREET CITY: BROOKLYN STATE: NY ZIP: 11233 MAIL ADDRESS: STREET 1: C/O HALSEY DRUG CO INC STREET 2: 1827 PACIFIC STREET CITY: BROOKLYN STATE: NY ZIP: 11233 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HALSEY DRUG CO INC/NEW CENTRAL INDEX KEY: 0000786947 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 110853640 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 16235 STATE ROAD 17 CITY: CULVER STATE: IN ZIP: 46511 BUSINESS PHONE: 847-705-7709 MAIL ADDRESS: STREET 1: 616 NORTH COURT STREET 2: . CITY: PALATINE STATE: IL ZIP: 60067 4 1 y99731_pac.xml MAIN DOCUMENT DESCRIPTION X0202 4 2004-08-12 0000786947 HALSEY DRUG CO INC/NEW HDGC.OB 0001056695 CLEMENS PETER A C/O ACURA PHARMACEUTICALS, INC. 616 N. NORTH COURT, SUITE 120 PALATINE IL 60067 0 1 0 0 Senior VP and CFO Employee Stock Options .13 2004-08-12 4 A 0 0 0 A 2014-08-12 Common Stock 375000 1000000 D 5% Convertible Senior Secured Debentures .5776 2004-08-13 4 C 0 127914 0 D 2004-08-13 2004-08-13 Preferred Stock 221458 0 D 5% Convertible Senior Secured Debentures .5776 2004-08-13 4 C 0 14589 0 D 2004-08-13 2004-08-13 Preferred Stock 25258 0 I by minor daughter 5% Convertible Senior Secured Debentures .5776 2004-08-13 4 C 0 13029 0 D 2004-08-13 2004-08-13 Preferred Stock 22557 0 I by minor son Series C-1 Convertible Preferred Stock 2004-08-13 4 C 0 221458 0 A Common Stock 221458 221458 D Series C-1 Convertible Preferred Stock 2004-08-13 4 C 0 25258 0 A Common Stock 25258 25258 I by minor daughter Series C-1 Convertible Preferred Stock 2004-08-13 4 C 0 22557 0 A Common Stock 22557 22557 I by minor son Options to purchase 375,000 shares of the Issuer's common stock, $.01 par value per share. Options vests and is exercisable 25% per annum commencing on March 9, 2005 until fully vested. 5% Convertible Senior Secured Debentures, due March 31, 2006, are automatically covnertible into Series C-1 Convertible Preferred Stock of the Issuer on August 13, 2004. 1-for-1 Immed. None /s/ Peter A. Clemens 2004-08-12 -----END PRIVACY-ENHANCED MESSAGE-----