4 1 im658184-form4.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.; IMMTC (Check all applicable) Thompson, T. Stephen [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/Day/Year below) Person, if an entity (voluntary) 09/25/2002 Chief Executive Officer and President 150 Fairway Drive, Suite 150 -------------------------------------- ------------------------------------ ---------------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Filing Date of (Check Applicable Line) Original [X] Form filed by One Reporting Person Vernon Hills, Illinois 60061 (Month/Day/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 or Indirect Ownership Day/ Following (I) (Instr. 4) Year) Reported (Instr. 4) Transaction(s) (Inst. 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 Secu- (Instr. Security Year) (Instr. 3, (Month/ Securi- (Instr. Benefi- rity: 3) 4, and 5) Day/ ties 5) cially Direct Year) (Instr. Owned (D) or 3 and 4) Follow- Indirect ing (I) Reported (Instr. Trans- 4) action(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) 2,000 Immedi- (1) Common (1) $25.00 (D) Convertible ately(1) Stock, per Preferred par share Stock, par value (2) value $0.01 $0.01 per per share share ("Series B ("Common Total: Preferred Stock") 58,067 Stock") ----------------------------------------------------------------------------------------------- -------------------------- Common $6.125 09/25/2002 P(1) 5,000 Immedi- 09/24 Common 5,000 (2) (D) Stock (2) ately /2007 Stock Warrants ("Warrants") ------------------------------------------------------------------------------------------------------------------------------------ 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/ T. Stephen Thompson 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)