-----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, DbhobqKGVgEI31T+/XMpWW78BwIXj/4evt6Uhz/V4ANJKxCqDQaAH/SefqKmS3wl HoVM1Ah2EQvoACdc6yYkhw== 0000950133-01-000483.txt : 20010213 0000950133-01-000483.hdr.sgml : 20010213 ACCESSION NUMBER: 0000950133-01-000483 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ZONAGEN INC CENTRAL INDEX KEY: 0000897075 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 760233274 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-52909 FILM NUMBER: 1533117 BUSINESS ADDRESS: STREET 1: 2408 TIMBERLOCH PL STREET 2: SUITE B-4 CITY: WOODLANDS STATE: TX ZIP: 77380 BUSINESS PHONE: 2813675892 MAIL ADDRESS: STREET 1: 2408 TIMBERLOCH PLACE B-4 CITY: THE WOODLANDS STATE: TX ZIP: 77380 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ROSE SAMUEL G CENTRAL INDEX KEY: 0001102663 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 5301 WISCONSIN AVENUE NW STREET 2: SUITE 510 CITY: WASHINGTON STATE: DC ZIP: 20015 BUSINESS PHONE: 2026863000 MAIL ADDRESS: STREET 1: 5301 WISCONSIN AVENUE NW STREET 2: SUITE 510 CITY: WASHINGTON STATE: DC ZIP: 20015 SC 13G/A 1 w45212sc13ga.txt AMENDMENT NO. 1 TO SCHEDULE 13G 1 ================================================================================ SEC POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION 1745 (3- CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM 98 DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. ================================================================================ ============================= UNITED STATES OMB APPROVAL SECURITIES AND EXCHANGE COMMISSION OMB Number: 3235-0145 WASHINGTON, DC 20549 Expires: October 31, 2002 Estimated average burden hours per response. . . 14.9 =============================
SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 1 )* -------- Zonagen, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $0.001 par value - -------------------------------------------------------------------------------- (Title of Class of Securities 98975L108 - -------------------------------------------------------------------------------- (CUSIP Number) January 1, 2001 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) *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 the disclosures provided in a prior cover page. The information required in 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 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). 2 CUSIP No. 98975L108 Page 2 of 6 - ------------------------------------------------------------------------------------- 1. Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). Samuel G. Rose - ------------------------------------------------------------------------------------- 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 536,000 Beneficially ----------------------------------------------------------------- 6. Shared Voting Power Owned by -0- Each ----------------------------------------------------------------- Reporting 7. Sole Dispositive Power Person with 536,000 ----------------------------------------------------------------- 8. Shared Dispositive Power -0- - ------------------------------------------------------------------------------------- 9. Aggregate Amount Beneficially Owned by Each Reporting Person 536,000 - ------------------------------------------------------------------------------------- 10. Check if the Aggregate Amount in Row (11) Excludes Certain Shares* [ ] - ------------------------------------------------------------------------------------- 11. Percent of Class Represented by Amount in Row (11) 4.7%* - ------------------------------------------------------------------------------------- 12. Type Percent of Class Represented by Amount in Row (11)* IN - -------------------------------------------------------------------------------------
* Computed on the basis of 11,316,632 shares outstanding on November 10, 2000 as reported in the Issuer's Quarterly Report on Form 10-Q for the Quarter Ended September 30, 2000 (as filed with the Securities and Exchange Commission on November 14, 2000 (the Issuer's most recent quarterly or annual report or subsequent current report filed with the Commission)). 3 CUSIP No. 98975L108 Page 3 of 6 ITEM 1(a): NAME OF ISSUER: Zonagen, Inc. ITEM 1(b): ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 2408 Timberloch Place, Suite B-4 The Woodlands, TX 77380 ITEM 2(a): NAME OF PERSON FILING: Samuel G. Rose ITEM 2(b): ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 5301 Wisconsin Avenue, NW Suite 510 Washington, DC 20015 ITEM 2(c): CITIZENSHIP: United States ITEM 2(d): TITLE OF CLASS OF SECURITIES: Common Stock, $ 0.001 par value ITEM 2(e): CUSIP NUMBER: 98975L108 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 (15 U.S.C. 78o). (b) [ ] Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c). 4 CUSIP No. 98975L108 Page 4 of 6 (c) [ ] Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c). (d) [ ] Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8). (e) [ ] An investment adviser in accordance with Section 240.13d-1(b)(1)(ii)(E); (f) [ ] An employee benefit plan or endowment fund in accordance with Section 240.13d-1(b)(1)(ii)(F); (g) [ ] A parent holding company or control person in accordance with Section 240.13d-1(b)(1)(ii)(G); (h) [ ] A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); (i) [ ] A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); (j) [ ] Group, in accordance with Section 240.13d-1(b)(1)(ii) (J). ITEM 4. OWNERSHIP. (a) Amount beneficially owned: 536,000 shares (b) Percent of class: 4.7% (Computed on the basis of 11,316,632 shares outstanding on November 10, 2000 as reported in the Issuer's Quarterly Report on Form 10-Q for the Quarter Ended September 30, 2000 (as filed with the Securities and Exchange Commission on November 14, 2000) the Issuer's most recent quarterly or annual report or subsequent current report filed with the Commission). (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: 536,000** (ii) Shared power to vote or direct the vote: -0- (iii) Sole power to dispose or direct the disposition of: 536,000** 5 CUSIP No. 98975L108 Page 5 of 6 (iv) Shared power to dispose or to direct the disposition of: -0- ** Of the 536,000 shares, 234,000 shares are held directly by Mr. Rose, 300,000 shares are held in a retirement account for the benefit of Mr. Rose and the remaining 2,000 shares are held in the Rose Family Trust, of which Mr. Rose is the sole trustee. ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. If this 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, check the following [X] ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not Applicable. ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not Applicable. ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. Not Applicable. ITEM 9. NOTICE OF DISSOLUTION OF GROUP. Not Applicable. ITEM 10. CERTIFICATION. By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not being held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect. 6 CUSIP No. 98975L108 Page 6 of 6 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 5, 2001 /s/ Samuel G. Rose ------------------------------------ Samuel G. Rose -----END PRIVACY-ENHANCED MESSAGE-----