-----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, Do5wwj2wITeVUEXXGvqtgJqKzDQONj+DY+lhFVGpzzPAqIH/z0P1ltHUayH//tYt gWlN+MSABDXLAMGDYrp/zg== 0000914121-02-001045.txt : 20020927 0000914121-02-001045.hdr.sgml : 20020927 20020927162928 ACCESSION NUMBER: 0000914121-02-001045 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020925 FILED AS OF DATE: 20020927 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: CHAN CECILIA CENTRAL INDEX KEY: 0001104492 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O IMMTECH INTERNATIONAL INC STREET 2: ONE NORTH EDN AVE #111 CITY: NEW YORK STATE: NY ZIP: 10282 MAIL ADDRESS: STREET 1: 93 PROCPECT AVE CITY: MONTCLAIR STATE: NJ ZIP: 07042 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: IMMTECH INTERNATIONAL INC CENTRAL INDEX KEY: 0000882509 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 391523370 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14907 FILM NUMBER: 02774961 BUSINESS ADDRESS: STREET 1: 150 FAIRWAY DRIVE STREET 2: SUITE 150 CITY: VERNON HILLS STATE: IL ZIP: 60061 BUSINESS PHONE: 8478690033 MAIL ADDRESS: STREET 1: 150 FAIRWAY DRIVE STREET 2: SUITE 150 CITY: VERNON HILLS STATE: IL ZIP: 60061 4 1 im658154_fomr4.txt STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP - ------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ------------------------------ FORM 4 WASHINGTON, D.C. 20549 OMB Approval - ------------------------- STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ------------------------------ [ ] Check this box if no OMB Number: 3235-0287 longer subject to Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Expires: January 31, 2005 Section 16. Form 4 Section 17(a) of the Public Utility Holding Company Act of 1935 or Estimated average burden or Form 5 obligations Section 30(f) of the Investment Company Act of 1940 hours per response.......0.5 may continue. See ------------------------------ Instruction 1(b).
(Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer Immtech International, Inc. (Check all applicable) Chan, Cecilia IMMTC [X] Director [ ] 10% Owner ------------------------------------ ----------------------------------------------- [X] Officer (give [ ] Other (specify (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for title below) Number of Reporting Month/Year below) Person, if an entity (voluntary) 09/25/2002 Executive Vice President - One North End Avenue Business Development ------------------------------------ --------------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Filing Date of (Check Applicable Line) Original [X] Form filed by One Reporting Person New York, New York 10282 (Month/Year) [ ] Form filed by More than One ------------------------------------ Reporting Person (City) (State) (Zip) - ------------------------------------------------------------------------------------------------------------------------------------ TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial (Month/ Owned Following or Indirect Ownership Day/ Reported Trans- (I) (Instr. 4) Year) action(s) Instr. (Instr. 4) 3 and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Code V Amount (A) or (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 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 4(b)(v). Page 1 of 2 SEC 1475 (08-02)
FORM 4 (continued)
TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of of sion or action action Derivative Exer- and of of ship Indirect Deriv- Exercise Date Code Securities cisable Amount Deriv- Deriv- Form of Beneficial ative Price of (Instr. Acquired (A) and Expi- of ative ative Deriv- Ownership Secu- Deriv- (Month/ 8) or Disposed ration Under- Secu- Secu- ative (Instr. 4) rity ative Day/ of (D) Date lying rity rities Security: (Instr. Security Year) (Instr. 3, (Month/ Securi- (Instr. Benefi- Direct (D) 3) 4, and 5) Day/ ties 5) cially or Indirect Year) (Instr. Owned (I) (Instr. 4) 3 and 4) Following Reporting Transaction(s) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Code V (A) (D) Date Expir- Title Amount Exerci- ation or sable Date Number of Shares - ------------------------------------------------------------------------------------------------------------------------------------ Series B $4.00(1) 09/25/2002 P(1) 925 Immed- (1) Common (1) $25.00 (D) Convertible iately Stock, per Preferred Stock, (1) par value share par value $0.01 $0.01 (2) per share per share ("Series B ("Common Preferred Stock") Total: Stock") 228,237 - -------------------------------------------------------------------------------------------------- -------------------------- Common Stock Warrants Immed- ("Warrants") $6.125 09/25/2002 P(1)(2) 2,312 iately 09/24/2007 Common 2,312 (2) (D) Stock - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) On September 25, 2002, Immtech International, Inc. (the "Company") closed private placement offerings of shares of its Series B Preferred Stock and related Warrants to purchase shares of the Company's Common Stock. Each share of Series B Preferred Stock is convertible by the holder at any time into shares of the Company's Common Stock at a conversion rate determined by dividing the $25.00 stated value, plus any accrued but unpaid dividends (the "Liquidation Price"), by a $4.00 conversion price (the "Conversion Price"), subject to antidilution adjustment. The Company may, at any time after September 24, 2003, require that any or all outstanding shares of Series B Preferred Stock be converted into shares of the Company's Common Stock, provided that the shares of Common Stock into which the Series B Preferred Stock is convertible is registered pursuant to an effective registration statement under the Securities Act of 1933, as amended. The number of shares of Common Stock to be received by holders of Series B Preferred Stock upon conversion will be determined by (i) dividing the Liquidation Price by the Conversion Price (provided that the closing market price for the Common Stock exceeds $9.00 for 20 consecutive trading days within 180 days prior to notice of conversion), or (ii) if the requirements of (i) are not met, the number of shares of Common Stock will be determined by dividing 110% of the Liquidation Price by the Conversion Price. The Company may, upon 30 days' notice, redeem any or all shares of Series B Preferred Stock by payment of the Liquidation Price to the holder, provided that the holder does not convert the Series B Preferred Stock into Common stock during the 30-day period. The Series B Preferred Stock has a liquidation preference equal to $25.00 per share, plus any accrued and unpaid dividends, prior to any payment to holders of Common Stock. (2) For each share of Series B Preferred Stock purchased at a price of $25.00 per share, each investor also received 2 1/2 Warrants to purchase shares of the Company's Common Stock. /s/ Cecilia Chan 09/27/2002 ------------------------------------------ --------------------------- ** Signature of Reporting Person Date ** 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. 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 of 2 SEC 1475 (08-02)
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