-----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, T8HMFXj84LFL4b7C0EECYqYRLotVc2K0vBySoU7Zt4V8G9bp726yCca8AFMghyoc yucWGfOqC4v/s+jWJKR2VQ== 0000743884-97-000004.txt : 19970211 0000743884-97-000004.hdr.sgml : 19970211 ACCESSION NUMBER: 0000743884-97-000004 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970207 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MACROCHEM CORP CENTRAL INDEX KEY: 0000743884 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 042744744 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-36722 FILM NUMBER: 97520012 BUSINESS ADDRESS: STREET 1: 110 HARTWELL AVE CITY: LEXINGTON STATE: MA ZIP: 02173 BUSINESS PHONE: 6178624003 MAIL ADDRESS: STREET 1: 110 HARTWELL AVENUE CITY: LEXINGTON STATE: MA ZIP: 02173 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MACROCHEM CORP CENTRAL INDEX KEY: 0000743884 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 042744744 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 110 HARTWELL AVE CITY: LEXINGTON STATE: MA ZIP: 02173 BUSINESS PHONE: 6178624003 MAIL ADDRESS: STREET 1: 110 HARTWELL AVENUE CITY: LEXINGTON STATE: MA ZIP: 02173 SC 13G 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Information statement pursuant to Rule 13d-1 and 13d-2 (Amendment No. _____)* MacroChem Corporation --------------------- (Name of Issuer) Common Stock, 0.01 par value per share -------------------------------------- (Title of Class of Securities) 556007 10 5 ----------- (CUSIP Number) Check the following box if a fee is being paid with the statement _____. A fee is not required only if the reporting person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7.) (Continued on following page(s)) * The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provision of the Act (however, see the Notes). CUSIP No. 556007 10 5 13G Page 2 of 5 Pages - -------------------------------------------------------------------------------- 1. NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Pierrette E. Samour ###-##-#### - -------------------------------------------------------------------------------- 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] - -------------------------------------------------------------------------------- 3. SEC USE ONLY - -------------------------------------------------------------------------------- 4. CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5. SOLE VOTING POWER NUMBER OF SHARES 439,710 BENEFICIALLY --------------------------------------------------- OWNED BY EACH 6. SHARED VOTING POWER REPORTING 33,500 PERSON --------------------------------------------------- WITH 7. SOLE DISPOSITIVE POWER REPORTING 439,710 --------------------------------------------------- 8. SHARED DISPOSITIVE POWER 33,500 - -------------------------------------------------------------------------------- 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 473,210 - -------------------------------------------------------------------------------- 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES PERSON [ ] - -------------------------------------------------------------------------------- 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 3.0% - -------------------------------------------------------------------------------- 12. TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! Page 3 of 5 Pages Item 1 (a). Name of Issuer: MacroChem Corporation (b). Address of Issuer's Principal Executive Offices: 110 Hartwell Avenue Lexington, MA 02173 Item 2 (a). Name of Person Filing: Pierrette E. Samour (b). Address of Principal Business Office, or , if None, Residence: 110 Hartwell Avenue Lexington, MA 02173 (c). Citizenship: United States (d). Title of Class of Securities: Common Stock, $0.01 par value per share (e). CUSIP Number: 556007 10 5 Item 3. If this statement is filed pursuant to Rules 13d-1(b) or 13d-2(b), check whether the person filing is a: (a) [ ] Broker or dealer registered under Section 15 of the Act, (b) [ ] Bank as defined in Section 3(a) (6) of the Act, (c) [ ] Insurance Company as defined in Section 3(a)(19)of the Act, (d) [ ] Investment Company registered under Section 8 of the Investment Company Act, (e) [ ] Investment Adviser registered under Section 203 of the Investment Advisers Act of 1940, (f) [ ] Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see Rule 13-d-1(b)(1)(ii)(F), (g) [ ] Parent Holding Company, in accordance with Rule 13d- 1(b)(ii)(G); see Item 7, (h) [ ] Group, in accordance with Rule 13d-1(b)(1)(ii)(H). Page 4 of 5 Pages Item 4. Ownership (a) Amount Beneficially Owned: See Item 9 of Cover Page (b) Percent of Class See Item 11 of Cover Page (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote See Item 5 of Cover Page (ii) Shared power to vote or to direct the vote See Item 6 of Cover Page (iii) Sole power to dispose or to direct the disposition of See Item 7 of Cover Page (iv) Shared power to dispose or to direct the disposition of See Item 8 of Cover Page Item 5. Ownership of Five Percent or Less of a Class: [ ] Statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities. Item 6. Ownership of More than Five Percent on Behalf of Another Person: Not applicable to reporting person. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company: Not applicable to reporting person. Item 8. Identification and Classification of Members of the Group: Not applicable to reporting person. Item 9. Notice of Dissolution of Group: Not applicable to reporting person. Item 10. Certification: Not applicable to reporting person. By signing below -I/we- certify that, to the best of my knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or as a participant in any transaction having such purpose of effect. Page 5 of 5 Pages SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date: February 7, 1997 By:/s/ Pierrette E. Samour ----------------------- Treasurer & Secretary -----END PRIVACY-ENHANCED MESSAGE-----