3 1 kl12031_form3.txt FORM 3 ------------------------------ OMB APPROVAL ------------------------------ OMB Number Expires: Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 ________________________________________________________________________________ 1. Name and Address of Reporting Person* Tyco International Ltd. -------------------------------------------------------------------------------- (Last) (First) (Middle) The Zurich Centre Second Floor, 90 Pitts Bay Road -------------------------------------------------------------------------------- (Street) Pembroke HM 08, Bermuda -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) 12/17/01 ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Paragon Trade Brands, Inc. ("PGTR.OB") ________________________________________________________________________________ 5. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [_] Form Filed by One Reporting Person [X] Form Filed by More than One Reporting Person (1) ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of 4 FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ Right to acquire (2) (2) (2) Common stock, 11,591,405 $43.50 (2) (2) par value $0.01 per share ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: Explanation of Responses: (1) See Attachments A and B hereto. (2) Tyco Healthcare Acquisition Corp. ("Tyco Acquisition") is a direct wholly-owned subsidiary of Tyco Healthcare Retail Group, Inc. ("Tyco Healthcare Retail"), which is an indirect wholly-owned subsidiary of Tyco International Ltd. ("Tyco"). Tyco Healthcare Retail and Tyco Acquisition have entered into a Stock Purchase and Merger Agreement, dated as of December 3, 2001 (the "Merger Agreement"), with Paragon Trade Brands, Inc. ("Paragon") and its majority stockholders, including a guarantee of Tyco, pursuant to which Tyco Acquisition will acquire approximately 96.6% of the stock of Paragon from these stockholders at a price of $43.50 per share in cash and thereafter Tyco Acquisition will be merged into Paragon under the short-form merger procedures of the Delaware general corporation law. The Merger Agreement will terminate on July 1, 2002 if the transactions that it contemplates are not consummated by that date. On December 17, 2001, early termination with respect to the transactions contemplated by the Merger Agreement was granted under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, and, as a result, the reporting persons may be deemed to be 10% owners of the common stock of Paragon for purposes of Section 16 of the Securities Exchange Act of 1934. By filing this form, the reporting persons do not concede that they are subject to Section 16 with respect to the Paragon common stock. TYCO INTERNATIONAL LTD. By: /s/ Mark H. Swartz 12/27/01 ----------------------------------- ------------ Mark H. Swartz Date Executive Vice President and Chief Financial Officer ** 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. 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 4 Attachment A Joint Filer Information Name: Tyco Healthcare Acquisition Corp. Address: One Tyco Park Exeter, New Hampshire 03833 Designated Filer: Tyco International Ltd. Issuer & Ticker Symbol: Paragon Trade Brands, Inc. ("PGTR.OB") Date of Event Requiring Statement: 12/17/01 Signature: TYCO HEALTHCARE ACQUISITION CORP. By: /s/ Jeffrey D. Mattfolk 12/27/01 ------------------------- -------- Name: Jeffrey D. Mattfolk Date Title: Vice President Page 3 of 4 Attachment B Joint Filer Information Name: Tyco Healthcare Retail Group, Inc. Address: 15 Hampshire Street Mansfield, MA 02048 Designated Filer: Tyco International Ltd. Issuer & Ticker Symbol: Paragon Trade Brands, Inc. ("PGTR.OB") Date of Event Requiring Statement: 12/17/01 Signature: TYCO HEALTHCARE RETAIL GROUP, INC. By: /s/ Jeffrey D. Mattfolk 12/27/01 ------------------------ -------- Name: Jeffery D. Mattfolk Date Title: Vice President Page 4 of 4