-----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, TXDDx794uoBR5m45OElM7Uia56Is/dyKvkLcOygRfG3WZf351onCS9Li9aMRUNp5 foiphkZX6abkM9kyHC4Enw== 0000905081-01-000001.txt : 20010130 0000905081-01-000001.hdr.sgml : 20010130 ACCESSION NUMBER: 0000905081-01-000001 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20010129 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MIRAVANT MEDICAL TECHNOLOGIES CENTRAL INDEX KEY: 0000933745 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 770222872 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-25544 FILM NUMBER: 1517514 BUSINESS ADDRESS: STREET 1: 336 BOLLAY DRIVE CITY: SANTA BARBARA STATE: CA ZIP: 93117 BUSINESS PHONE: 8056859880 MAIL ADDRESS: STREET 1: 336 BOLLAY DRIVE CITY: SANTA BARBARA STATE: CA ZIP: 93117 FORMER COMPANY: FORMER CONFORMED NAME: PDT INC /DE/ DATE OF NAME CHANGE: 19941214 COMPANY DATA: COMPANY CONFORMED NAME: SHACKNAI JONAH CENTRAL INDEX KEY: 0000905081 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR IRS NUMBER: 091462383 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 8125 N HAYDEN RD CITY: SCOTTSDALE STATE: AZ ZIP: 85258 BUSINESS PHONE: 6028088800 MAIL ADDRESS: STREET 1: 8125 N HAYDEN RD CITY: SCOTTSDALE STATE: AZ ZIP: 85258 5 1 0001.txt 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) Jonah Shacknai 336 Bollay Drive Santa Barbara, CA 93117 2. Issuer Name and Ticker or Trading Symbol Miravant Medical Technologies (MRVT) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/00 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) 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 - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option $9.3130 01/01/00 A 25,000 01/01/01 01/01/10 (right to buy) Non-Qualified Stock Option $9.3130 01/01/00 (1) J 25,000 01/01/01 01/01/10 (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 - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option 01/01/00 Common Stock 25,000 $9.3130 D Direct (right to buy) Non-Qualified Stock Option 01/01/00 Common Stock 25,000 0 D Direct (right to buy) (1) Explanation of Responses: (1) Options were transferred to a trust administered by an independent trustee for the benefit of Mr. Shacknai's children for which Mr. Shacknai has no voting power. Thus, Mr. Shacknai disclaims beneficial ownership.
SIGNATURE OF REPORTING PERSON /S/ Jonah Shacknai - ------------------ Jonah Shacknai DATE: January 16, 2001
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