5 1 f5_0314-2002protein.txt FORM 5 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [X] Form 3 Holdings Reported [X] Form 4 Transactions Reported -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Johnson & Johnson -------------------------------------------------------------------------------- (Last) (First) (Middle) One Johnson & Johnson Plaza -------------------------------------------------------------------------------- (Street) New Brunswick, New Jersey 08933 -------------------------------------------------------------------------------- (City) (State) (Zip) -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Protein Polymer Technologies, Inc. (PPTI.OB) -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) -------------------------------------------------------------------------------- 4. Statement for Month/Year 12/31/01 -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) [ ] Form filed by one Reporting Person [X] Form filed by more than one Reporting Person -------------------------------------------------------------------------------- * If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Page 1 of 4 ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. 3. ----------------------------- of Issuer's (D) or Indirect 1. Transaction Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 3/18/96 X4 220,000 A $1.25 520,480 (13) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 8/26/96 X4 300,480 A $1.25 520,480 (13) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/6/97 P4 400,000 A $2.50 920,480 (13) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) Page 2 of 4 FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Series C Common Preferred Stock (1) 6/29/94 P3 11,000 6/29/95 (2) Stock (3) $100 11,000 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series C Common Stock Warrants Common (right to buy) $1.25 6/29/94 P3 220,000 Immed. (4) Stock 220,000 (5) 220,000 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series C. Common Preferred Stock (1) 9/14/95 J4(6) 11,000 6/29/95 (2) Stock (3) -0- ------------------------------------------------------------------------------------------------------------------------------------ Series D Common Preferred Stock (7) 9/14/95 P4 27,317 9/14/97 (8) Stock (3) $100(6) 27,317 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series D Common Stock Warrants Common (right to buy) $1.25 9/14/95 P4 300,480 Immed. (9) Stock 300,480 (5) 300,480 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series C Common Stock Warrants Common (right to buy) $1.25 3/18/96 X4 220,000 Immed. (4) Stock 220,000 -0- ------------------------------------------------------------------------------------------------------------------------------------ Series D Common Stock Warrants Common (right to buy) $1.25 8/26/96 X4 300,480 Immed. (9) Stock 300,480 -0- ------------------------------------------------------------------------------------------------------------------------------------ Series D J4 Common Preferred Stock (7) 4/24/98 (10) 26,420 9/14/97 (8) Stock (3) 897 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series F Common Preferred Stock (7) 4/24/98 P4 26,420 Immed. (8) Stock (3) (10) 26,420 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series H Common 1,078,800 $100(12) Preferred Stock $0.75 7/24/01 P4 8,091 Immed. (11) Stock (3) 8,091 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series H First Com- mon Stock Warrants Common (right to buy) $1.50 7/24/01 P4 121,365 Immed. 7/31/02 Stock 121,365 (5) 121,365 (13) ------------------------------------------------------------------------------------------------------------------------------------ Series H Second Com- mon Stock Warrants Common (right to buy) $2.00 7/24/01 P4 80,910 Immed. 7/31/03 Stock 80,910 (5) 80,910 (13) ====================================================================================================================================
Explanation of Responses: (1) $1.25 if the market price of the Common Stock at the time of conversion is less than $1.25, the market price of the Common Stock if such market price is between $1.25 and $3.75 inclusive at the time of conversion, and $3.75 if the market price of the Common Stock is greater than $3.75 at the time of conversion. (2) Redeemable at the option of the issuer beginning on June 29, 1999. Automatically converted to Common Stock upon closing of a firm commitment public offering of the issuer's Common Stock with a minimum offering price of $2.50 per share. Convertible to Common Stock at the option of the issuer if the market price of the Common Stock is greater than or equal to $5 per share for 20 consecutive trading days. (3) Equal to the number of preferred shares times $100 per share stated value divided by the conversion price. Page 3 of 4 (4) Exercisable until the earlier of July 6, 1996 or 30 days after notice to the holder that more than 66-2/3% of the Series C Preferred Stock outstanding on July 6, 1994 has been converted to Common Stock. (5) Nominally priced warrants issued in connection with the corresponding series of preferred stock. (6) The purchase price for all 27,317 shares of Series D Preferred Stock was $2,731,780, which was paid as follows: $1,250,000 in cash, $252,480 through forgiveness of indebtedness owed by the issuer to the purchaser, and $1,229,300 through conversion of all 11,000 shares of Series C Preferred Stock held by the purchaser (including accrued dividends on such stock). (7) Lesser of $3.75 or the market price of the Common stock at the time of conversion. (8) Redeemable at the option of the issuer beginning on September 13, 1999. Automatically converted to Common Stock upon closing of a firm commitment public offering of the issuer's Common Stock with a minimum offering price of $2.50 per share. Convertible to Common Stock at the option of the issuer if the market price of the Common stock is greater than or equal to $5 per share for 20 consecutive trading days. (9) Exercisable until the earlier of September 14, 1997 or 30 days after notice to the holder that more than 50% of the then- outstanding Series D Preferred Stock has been converted to Common Stock. (10) The 26,420 shares of Series F Preferred Stock were issued in exchange for the surrender of 26,420 shares of Series D Preferred Stock. (11) Not redeemable. Automatically converted to Common Stock upon closing of a firm commitment public offering of the issuer's Common Stock worth at least $10 million at a minimum offering price of $5.00 per share. (12) The purchase price for all 8,091 shares of Series H Preferred Stock was $809,129, which was paid as follows: $400,000 in cash and $409,129 through forgiveness of indebtedness owed by the issuer to the purchaser. (13) The securities reported herein are directly beneficially owned by Johnson & Johnson Development Corporation, a wholly-owned subsidiary of Johnson & Johnson. Johnson & Johnson may be deemed to indirectly beneficially own these securities.
/s/ Michael H. Ullmann March 26, 2002 --------------------------------------------- ----------------------- **Signature of Reporting Person Date Name: Michael H. Ullmann Title: Secretary ** 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 provided is insufficient, see Instruction 6 for procedure. Joint Filer Information ----------------------- Name: Johnson & Johnson Development Corporation Address: One Johnson & Johnson Plaza New Brunswick, New Jersey 08933 Designated Filer: Johnson & Johnson Issuer Name & Ticker Symbol: Protein Polymer Technologies, Inc. (PPTI.OB) State for Month/Year: 12/31/01 Signature: /s/ Eric B. Jung March 26, 2002 --------------------------- ------------------------ Name: Eric B. Jung Date Title: Secretary Page 4 of 4