-----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, WVQiz1CeaXLgilTVck6Bct5FGgyEhRaVQWlxZfSRaQE6huWjSGMQfFMXIw94n9y2 a9Wxb54M7x4HIFE/2L+n8A== 0000950153-01-501410.txt : 20020412 0000950153-01-501410.hdr.sgml : 20020412 ACCESSION NUMBER: 0000950153-01-501410 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011129 FILED AS OF DATE: 20011210 COMPANY DATA: COMPANY CONFORMED NAME: CHAM BILL E CENTRAL INDEX KEY: 0001162532 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 1645 LPSWICH ROAD, UNIT 14 CITY: ROCKLEA STATE: A1 ZIP: 00000 BUSINESS PHONE: 61732744452 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LIPID SCIENCES INC/ CENTRAL INDEX KEY: 0000071478 STANDARD INDUSTRIAL CLASSIFICATION: LAND SUBDIVIDERS & DEVELOPERS (NO CEMETERIES) [6552] IRS NUMBER: 430433090 STATE OF INCORPORATION: AZ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-00497 FILM NUMBER: 1810068 BUSINESS ADDRESS: STREET 1: 7068 KOLL CENTER PARKWAY STREET 2: SUITE 401 CITY: PLEASANTON STATE: CA ZIP: 94566 BUSINESS PHONE: 925-249-4000 MAIL ADDRESS: STREET 1: 7068 KOLL CENTER PARKWAY STREET 2: SUITE 401 CITY: PLEASANTON STATE: CA ZIP: 94566 FORMER COMPANY: FORMER CONFORMED NAME: NEW MEXICO & ARIZONA LAND CO DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: NZ CORP DATE OF NAME CHANGE: 20000810 3 1 p65933ee3.txt 3 FORM 3 ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0104 Expires: December 31, 2001 Estimated average burden hours per response: 0.5 ------------------------------ U.S. 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print Or Type Responses) ________________________________________________________________________________ 1. Name and Address of Reporting Person* Cham Bill E. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 190 Woodlands Drive - -------------------------------------------------------------------------------- (Street) Thornlands, Queensland, Australia 4164 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) 11/29/2001 ________________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person (Voluntary) ________________________________________________________________________________ 4. Issuer name and Ticker or Trading Symbol Lipid Sciences, Inc. (LIPD) ________________________________________________________________________________ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [x] Director [x] 10% Owner [_] Officer (give title below) [_] Other (specify below) ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable Line) [_] Form Filed by One Reporting Person [x] Form Filed by More Than One Reporting Person ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 4,755,013 I (1) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities owned directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 5(b)(v). Page 1 of 3 (Over) SEC 1473 (3-99) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: (1) These shares are owned directly by KAI International, LLC, a ten percent owner of the issuer, and indirectly by Bill E. Cham and Tania R. Chase as managers of KAI International, LLC. Bill E. Cham is a director of the issuer. Bill E. Cham and Tania R. Chase disclaim beneficial ownership of the reported securities except to the extent of their pecuniary interests therein. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Bill E. Cham 12/10/01 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date Note: File three copies of this form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 of 3 Page 2 Joint Filer Information Name: Tania R. Chase Address: 190 Woodlands Drive Thornlands, Queensland 4157 Australia Designated Filer: Bill E. Cham Issuer & Ticker Symbol: Lipid Sciences, Inc. (LIPD) Date of Event Requiring Statement: 11/29/2001 Signature: /s/ Tania R. Chase ---------------------- Name: KAI International, LLC Address: 190 Woodlands Drive Thornlands, Queensland 4157 Australia Designated Filer: Bill E. Cham Issuer & Ticker Symbol: Lipid Sciences, Inc. (LIPD) Date of Event Requiring Statement: 11/29/2001 Signature: KAI INTERNATIONAL, LLC By: /s/ Tania R. Chase ---------------------- Tania R. Chase, Manager By: /s/ Bill E. Cham ---------------------- Bill E. Cham, Manager Page 3 of 3 -----END PRIVACY-ENHANCED MESSAGE-----