-----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, CoGAbMzWJBq1g7YF9b1h2LystcVjHJi9WQgJhlLq84qKLp2LhnHIiC7AhNrL2rff bPq1Dh6u8HEHJ5b8Ce9ULg== 0001047469-98-000368.txt : 19980108 0001047469-98-000368.hdr.sgml : 19980108 ACCESSION NUMBER: 0001047469-98-000368 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980107 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: IMMUNE RESPONSE CORP CENTRAL INDEX KEY: 0000817785 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 330255679 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-18006 FILM NUMBER: 98502302 BUSINESS ADDRESS: STREET 1: 5935 DARWIN COURT CITY: CARLSBAD STATE: CA ZIP: 92008 BUSINESS PHONE: 6194317080 MAIL ADDRESS: STREET 1: 5935 DARWIN COURT CITY: CARLSBAD STATE: CA ZIP: 92008 COMPANY DATA: COMPANY CONFORMED NAME: GLAVIN JAMES B CENTRAL INDEX KEY: 0001048640 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 4440 143RD PL N E CITY: BELLEVUE STATE: WA ZIP: 98007 MAIL ADDRESS: STREET 1: 4440 143RD PL N E CITY: BELLEVUE STATE: WA ZIP: 98007 4 1 FORM 4
- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ----------------------------- / / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287 LONGER SUBJECT TO EXPIRES: SEPTEMBER 30, 1998 SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5 CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 ----------------------------- INSTRUCTION 1(b). (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Glavin James B. The Immune Response Corporation (IMNR) X Director 10% Owner ---- ---- - --------------------------------------------------------------------------------------------- Officer (give Other (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify Number of Reporting Month/Year below) below Person (Voluntary) ----------------- ------------------ 4440 143rd Place NE ###-##-#### December 1997 - -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original ---Form filed by One Reportng Person (Month/Year) ---Form filed by More than One Bellevue WA 98007 Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 8) Owned at Direct Bene- (Month/ End of (D) or ficial Day/ ------------------------------------------- Month Indirect Owner- Year) (A) or (I) ship Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/01/97 S 10,000 D $12.00 - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/02/97 S 1,000 D $12.50 - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/04/97 S 9,000 D $13.00 110,527 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (7-97) 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 CONTROL NUMBER.
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. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- (Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex- Exercise Date (Instr. 8) quired (A) or Dis- piration Date Price of (Month/ posed of (D) (Month/Day/ Deriv- Day/ (Instr. 3, 4, and 5) Year) ative Year) Security -------------------- Date Expira- -------------------------------------- Exer- tion cisable Date Code V (A) (D) - ------------------------------------------------------------------------------------------------------------------------ Right to Buy Common Stock Option $8.75 05/22/97 see below 05/22/07* - ------------------------------------------------------------------------------------------------------------------------ Right to Buy Common Stock Option** $3.25 11/23/91 see below 11/23/01 - ------------------------------------------------------------------------------------------------------------------------ Right to Buy Common Stock Option** $3.25 12/15/92 see below 12/15/02 - ------------------------------------------------------------------------------------------------------------------------ Right to Buy Common Stock Option** $3.25 09/19/94 see below 09/19/04 - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ 7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature lying Securities of of Deriv- ship of In- (Instr. 3 and 4) Deriv- ative Form direct ative Securi- of De- Bene- Secur- ties rivative ficial ity Bene- Secu- Own- (Instr. ficially rity: ership 5) Owned Direct (Instr. 4) at End (D) or Amount or of Indi- Title Number of Month rect (I) Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------ Common Stock 6,250 6,250 D - ------------------------------------------------------------------------------------------ Common Stock 135,000 135,000 D - ------------------------------------------------------------------------------------------ Common Stock 75,000 75,000 D - ------------------------------------------------------------------------------------------ Common Stock 86,250 86,250 D - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ Explanation of Responses: * Options vest fully one-year from date of grant. ** Options were repriced on April 19, 1995, with a one-year blackout period, and are exempt pursuant to Rule 16(b)31. All options vest daily over a four year period beginning on the date of grant. ----------------------------------- ----------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date 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 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 SEC 1474 (7-97)
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