-----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, V6lgnXlqZn5Fa5rrV/4kHd2Y2OrNA5/7bhWIRjvEDvns+lxzEOCE7DX0yd2sCbP5 9GF7V1Erjw+NIHGjQoG05w== 0000950123-01-002142.txt : 20010312 0000950123-01-002142.hdr.sgml : 20010312 ACCESSION NUMBER: 0000950123-01-002142 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010228 FILED AS OF DATE: 20010309 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HALSEY DRUG CO INC/NEW CENTRAL INDEX KEY: 0000786947 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 110853640 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-10113 FILM NUMBER: 1564623 BUSINESS ADDRESS: STREET 1: 1827 PACIFIC ST CITY: BROOKLYN STATE: NY ZIP: 11233 BUSINESS PHONE: 7184677500 MAIL ADDRESS: STREET 2: 695 N. PERRYVILLE ROAD CITY: ROCKFORD STATE: IL ZIP: 61107 COMPANY DATA: COMPANY CONFORMED NAME: SKELLY WILLIAM G CENTRAL INDEX KEY: 0001058352 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O CENTRAL BIOMEDIA STREET 2: 9900 PFLUMM CITY: LENEXA STATE: KS ZIP: 64155 MAIL ADDRESS: STREET 1: C/O HALSEY DRUG CO INC STREET 2: 1827 PACIFIC STREET CITY: BROOKLYN STATE: NY ZIP: 11233 4 1 y46307ae4.txt FORM 4 1
- --------- --------------------------- FORM 4 OMB APPROVAL - --------- U.S. SECURITIES AND EXCHANGE COMMISSION --------------------------- [ ] Check this box if no longer WASHINGTON, D.C. 20549 OMB Number 3235-0257 subject to Section 16. Form Expires: February 1, 2001 4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden continue. See Instruction 1(b). hours per response....1.0 --------------------------- 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 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person| 2. Issuer Name and Ticker or Trading Symbol | 6. Relationship of Reporting Person | | to Issuer (Check all applicable) Skelly William G. | Halsey Drug Co., Inc. Symbol: HDGC | _X_ Director ___ 10% Owner - -------------------------------------------------------------------------------------------| ___ Officer (give ___ Other (specify (Last) (First) (Middle) | 3. IRS or Social | 4. Statement for | title below) | Security Number | Month/Year | below) C/o Halsey Drug Co., Inc. 695 N. | of Reporting | 02/01 | Perryville Rd. Bldg. 2 | Person (Voluntary) |-------------------------| - ---------------------------------------| | 5. If Amendment, | (Street) | | Date of Original | | | (Month/Year) | Rockford, Illinois 61107 | | | - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) | Table I - NonDerivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security | 2.Transaction | 3.Transaction | 4.Securities Acquired(A) | 5.Amount of | 6.Owner-| 7.Nature (Instr. 3) | Date | Code | or disposed of (D) | Securities | ship | of | (Month/Day/ | (Instr. 8) | (Instr. 3, 4, and 5) | Beneficially| Form: | Indirect | Year) | | | Owned at End| Direct | Bene- | |---------------|--------------------------| of Month | (D) or | ficial | | | | | (A) | | (Instr. 3 | Indirect| Owner- | | | | | or | | and 4) | (I) | ship | | CODE | V | Amount | (D) | Price | |(Instr.4)|(Instr.4) - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- Common Stock | | | | | | | 10,000 | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (over) (Print or Type Responses) SFC 1474 (3/91) *See footnote 2 on Table II
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FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ---------------------------------------------------------------------------------------------------------------- 1.Title of Derivative Security | 2.Conversion | 3.Transaction | 4.Transaction | 5.Number of | 6.Date Exer- (Instr. 3) | or Exercise | Date | Code | Derivative | cisable and | Price of | | (Instr. 8) | Securities | Expiration Date | Derivative | (Month/Day/ | | Acquired (A) | | Security | Year) | | or Disposed | (Month/Day/Year) | | | | of (D) |------------------ | | | | (Instr. 3, | | | | | | 4, and 5) | Date | Expir- | | |---------------|--------------| Exer- | ation | | | Code | V | (A) | (D) | cisable | Date - ----------------------------------------------------------------------------------------------------------------- Non-qualified Stock Options | $2.375 | 2/19/98 | A | | | | (1) | 2/19/08 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.1875 | 2/19/99 | A | | | | (1) | 2/19/09 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.875 | 2/17/00 | A | | | | (1) | 2/17/10 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.1125 | 6/29/00 | A | | | | (1) | 6/29/10 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.140 | 2/15/01 | A | | | | (1) | 2/15/11 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - ------------------------------------------------------------------------------------------------- 7.Title and Amount |8. Price of |9. Number of | 10. Ownership |11. Nature of of Underlying | Derivative | Derivative | Form of | Indirect Securities | Security | Securities | Derivative | Beneficial (Instr. 3 and 4) | (Instr. 5) | Beneficially | Security; | Ownership | | Owned at End | Direct (D) or | (Instr. 4) - ----------------------------| | of Month | Indirect (I) | | | | (Instr. 4) | (Instr. 4) | | Amount or | | | | | Number of | | | | Title | Shares | | | | - ------------------------------------------------------------------------------------------------- Common Stock | 115,000 | | 115,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 15,000 | | 130,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 15,000 | | 145,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 25,000 | | 170,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 10,000 | | 180,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | |
(1) Options vest 25% quarterly By: /s/ William Skelly March 2, 2001 ------------------ ------------- *Signature of Reporting Person 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 provided is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----