5 1 c60073fe5.txt FORM 5 1 ------ FORM 5 ------ / / Check box if no U.S. SECURITIES AND EXCHANGE COMMISSION longer subject to WASHINGTON, DC 20549 Section 16. Form 4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP obligations may continue. See Filed pursuant to Section 16(a) of the Securities Instruction 1(b) Exchange Act of 1934, / / Form 3 Holdings Section 17(a) of the Public Utility Reported Holding Company Act of 1935 or Section 30(f) of / / Form 4 the Investment Company Act Transactions of 1940 Reported ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person(1) 2. Issuer Name and Ticker or Trading Symbol 7. Individual or Joint/Group Filing (Check applicable line) X Form filed by One Reporting ---- Person Form Filed by More Than One Rothwell, Timothy G. PHARMACIA CORPORATION (PHA) ---- reporting person --------------------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS Identification 4. Statement for Number of Reporting Month/Year Person, if an Entity (Voluntary) 100 Route 206 North December 31, 2000 ------------------------------------------- ------------------- (Street) 5. If Amendment, Peapack, New Jersey 07977 Date of Original ------------------------------------------- (Month/Year) (City) (State) (Zip) 6. Relationship of Reporting Person to Issuer (Check all applicable) Director 10% Owner ---- --- X Officer (give Other (Specify ---- title --- below) below) SENIOR VICE PRESIDENT ------------------------ ------------------------------------------------------------------------------------------------------------------------------------ TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned Form: direct (Instr. 8) at End Month Direct Benefi- (Month/ (Instr. 3 and 4) (D) or cial Day/ ---------------------------- Indirect Owner- Year) Code Amount (A) or (D) Price (I) ship (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 17,057 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,468 I By Savings Plans ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ (1) If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly
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FORM 5 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or --------------- Exer- tion Title Number of (A) (D) cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $31.30 (2) 1/26/08 Common 43,070 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $33.64 (2) 2/24/08 Common 117,018 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $45.90 (2) 2/16/09 Common 119,000 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $42.86 (2) 1/25/08 Common 777 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $41.23 (2) 2/14/10 Common 119,000 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $51.59 (3) 6/1/10 Common 125,000 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $51.59 (2) 2/24/08 Common 1,292 Stock ------------------------------------------------------------------------------------------------------------------------------------ Option (right to buy) $51.59 (2) 1/25/08 Common 1,291 Stock ------------------------------------------------------------------------------------------------------------------------------------ Performance 1-for-1 6/1/00 A 100,000 (4) (4) Common 100,000 $51.59 Share Units Stock ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of 10. Ownership 11. Nature of Derivative of Derivative Indirect Securities Security: Beneficial Beneficially Direct (D) Ownership Owned at End or Indirect (I) (Instr. 4) of Month (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------- 43,070 D ------------------------------------------------------------------------------------------------------- 160,088 D ------------------------------------------------------------------------------------------------------- 279,088 D ------------------------------------------------------------------------------------------------------- 279,865 D ------------------------------------------------------------------------------------------------------- 398,865 D ------------------------------------------------------------------------------------------------------- 523,865 D ------------------------------------------------------------------------------------------------------- 525,157 D ------------------------------------------------------------------------------------------------------- 526,448 D ------------------------------------------------------------------------------------------------------- 626,448 D ------------------------------------------------------------------------------------------------------- Explanation of Responses: (1) NOT USED. (2) Options are currently exercisable. (3) Options become exercisable for one-third of the shares on each of 6/1/01, 6/1/02 and 6/1/03. (4) Performance share units will be earned on the earlier of 12/31/04 (unless employment terminates) or the date of a change-in-control with the ultimate payout in the range of 0% to 125% of the number of units granted (100,000) based upon the Company's relative total shareholder return compared to peer companies and absolute total shareholder return over the performance period. /s/ Don Schmitz* 02/14/01 ------------------------------- -------- Signature of Reporting Person(1) Date *Don Schmitz, attorney-in-fact for Timothy G. Rothwell. (1) Intentional misstatements or omission 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. Page 2 If space provided is insufficient, see Instruction 6 for procedure.