-----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, SmzSCZLzovoty1X78Ux0gkFL9a4+VViMKXGGtNHfCLqvVAAdmt7EyHZmOTYTE/Rz 6FxcE5yADjjSyjEWtCttJA== 0000926236-02-000017.txt : 20020414 0000926236-02-000017.hdr.sgml : 20020414 ACCESSION NUMBER: 0000926236-02-000017 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020208 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MEDICHEM LIFE SCIENCES INC CENTRAL INDEX KEY: 0001115512 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] IRS NUMBER: 363518660 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-31781 FILM NUMBER: 02531854 BUSINESS ADDRESS: STREET 1: 12305 SOUTH NEW AVENUE CITY: LEMONT STATE: IL ZIP: 60439 MAIL ADDRESS: STREET 1: 12305 SOUTH NEW AVENUE CITY: LEMONT STATE: IL ZIP: 60439 COMPANY DATA: COMPANY CONFORMED NAME: FLAVIN JOHN L CENTRAL INDEX KEY: 0001126556 OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O MEDICHEM LIFE SCIENCES INC STREET 2: 12305 SOUTH NEW AVENUE CITY: LEMONT STATE: IL ZIP: 60439 BUSINESS PHONE: 6302571500 MAIL ADDRESS: STREET 1: C/O MEDICHEM LIFE SCIENCES INC STREET 2: 12305 SOUTH NEW AVENUE CITY: LEMONT STATE: IL ZIP: 60439 5 1 jflavin.txt 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. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) Flavin, John 2501 Davey Road Woodridge, IL 60517 2. Issuer Name and Ticker or Trading Symbol MediChem Life Sciences (MCLS) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/01 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Executive Vice President 7. 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 Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Security 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I - ------------------------------------------------------------------------------------------------------------------------------------ Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration - ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right $4.63 01/02/01 (1) A 73,434 01/02/11 to buy) Incentive Stock Option (right $4.63 01/02/01 (2) A 25,000 01/02/11 to buy) Non-Qualified Stock Option $1.29 09/10/01 (3) A 67,275 09/10/11 (right to buy) Non-Qualified Stock Option $1.29 09/10/01 (4) A 27,538 09/10/11 (right to buy) Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year - ------------------------------------------------------------------------------------------------------------------------------------ Incentive Stock Option (right 01/02/01 Common Stock 73,434 D Direct to buy) (1) Incentive Stock Option (right 01/02/01 Common Stock 25,000 98,434 D Direct to buy) (2) Non-Qualified Stock Option 09/10/01 Common Stock 67,275 D Direct (right to buy) (3) Non-Qualified Stock Option 09/10/01 Common Stock 27,538 94,813 D Direct (right to buy) (4) Explanation of Responses: (1) The options vest and become exercisable as follows: 50% vest on 01/02/01 and 50% vest on 01/02/02. (2) The options vest and become exercisable as follows: 33% on 01/02/02 and continue to vest 1/36 monthly through 01/02/04 (3) The Options vest and become exercisable as fellows: 33% on 09/10/02 and continue to vest 1/36 monthly through 9/10/04 (4) The options vest and become exercisable immediately upon issuance
SIGNATURE OF REPORTING PERSON /S/ Flavin, John DATE 02/07/02
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