FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 04/14/2004 |
3. Issuer Name and Ticker or Trading Symbol
CORCEPT THERAPEUTICS INC [ CORT ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 606,060 | I | by James and Pamela Wilson Family Partners(6) |
Common Stock | 1,164,879 | I | by James N. Wilson and Pamela D. Wilson Trust(6) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series A Preferred Stock | (1) | (4) | Common Stock | 277,779 | (2) | I | by James N. Wilson and Pamela D. Wilson Trust(6) |
Series B Preferred Stock | (1) | (4) | Common Stock | 120,003 | (2) | I | by James N. Wilson and Pamela D. Wilson Trust(6) |
Series BB Preferred Stock | (1) | (4) | Common Stock | 25,433 | (3) | I | James N. Wilson and Pamela D Wison Trust(6) |
Series A Preferred Stock | (1) | (4) | Common Stock | 13,887 | (2) | I | David Wilson(5) |
Series B Preferred Stock | (1) | (4) | Common Stock | 4,998 | (2) | I | David Wilson(5) |
Series BB Preferred Stock | (1) | (4) | Common Stock | 6,358 | (3) | I | David Wilson(5) |
Series A Preferred Stock | (1) | (4) | Common Stock | 85,893 | (2) | I | Ed West and Beth Ann Wilson West(5) |
Series B Preferred Stock | (1) | (4) | Common Stock | 9,999 | (2) | I | Ed West and Beth Ann Wilson West(5) |
Series C Preferred Stock | (1) | (4) | Common Stock | 8,954 | (3) | I | Ed West and Beth Ann Wilson West(5) |
Series A Preferred Stock | (1) | (4) | Common Stock | 27,777 | (2) | I | Arterburn/Watters Trust(5) |
Series B Preferred Stock | (1) | (4) | Common Stock | 9,999 | (2) | I | Arterburn/Watters Trust(5) |
Series BB Preferred Stock | (1) | (4) | Common Stock | 6,358 | (3) | I | Wilson Family Trust(5) |
Explanation of Responses: |
1. Immediately |
2. Each share is convertible without consideration into three (3) shares of Common Stock. |
3. Each share is convertible without consideration into one (1) share of Common Stock. |
4. Not applicable |
5. The reporting person has voting control of the shares and disclaims beneficial ownership of them. |
6. The reporting person disclaims beneficial ownership to the shares, except to the extent of his pecuniary interest therin. |
/s/ Fred Kurland, CFO of Corcept Therapeutics Incorporated attorney-in-fact | 04/14/2004 | |
** Signature of Reporting Person | Date | |
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 5 (b)(v). | ||
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |