5 1 0001.txt FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 __Check this box if no longer subject to Section 16. Form 4 or OMB APPROVAL Form 5 obligations may continue. OMB Number: 3235-0287 See Instruction 1(b). Expires: September 30, 1998 __Form 3 Holdings Reported Estimated average burden __Form 4 Holdings Reported hours per response.......1.0 (Print or Type Responses) STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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(s) BioTime, Inc. (BTX) to Issuer (Check all applicable) Waitz Harold D. __X__ Director _____ 10% Owner (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for __X__ Officer(give _____ Other Number of Reporting Month/Year title below) specify below) Person (Voluntary) 12/00 Vice President of Regulatory Affairs ------------------------------------ 935 Pardee Street (Street) 5. If Amendment, 7. Individual or Joint/Group Filing Date of Original (Check Applicable Line) (Month/Year) _X_Form filed by One Reporting Person Berkeley CA 94710 ___Form filed by More than One (City) (State) (Zip) Reporting Person
Table 1 -- 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 of (Instr. 3) action action or Disposed of (D) Securities ship Indirect Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial (Instr. 8) Owned at Direct Ownership End of Issuer's (D) or (Month/ Fiscal Year Indirect Day/ Inst. 3 and 4) (I) Year) (A)or Amount (D) Price (Instr. 4) Instr. 4) ----------------------------------------------------------------------------------------------------------------------------------- Common Shares, 424,166* D no par value ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. *If the form is filed by more than one reporting person,see Instruction 4(b)(v). (Over) SEC 2270(7-97)
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 Security 2. Conver- 3. Trans- 4. Trans- 5.Number of Deriv- 6. Date Exer- (Instr. 3) sion or action action ative Securities Ac- cisable and Exercise Date Code quired (A) or Dis- Expiration Price of (Instr. 8) posed of (D) Date Deri- (Month/ (Instr. 3, 4 and 5) (Month/Day/ vative Day/ Year) Security Year) Date Expir- (A) (D) Exer- ation cisable Date ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------------------------------
7. Title and Amount 8. Price 9. Number 10.Owner- 11. Nature of Underlying of of deriv- ship of Securities Deriv- ative Form of Indirect (Instr. 3 and 4) ative Secur- Deriv- Benefi- Secur- ities ative cial ity Bene- Security: Owner- Amount or (Instr. ficially Direct ship Title Number of 5) Owned (D)or (Instr.4) Shares at End Indirect of Year (I) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ================================================================================ Explanation of Responses: *Includes 2,100 shares beneficially owned by Dr. Waitz's minor children. ** 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 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 valid OMB Number.
/s/Harold D. Waitz January 9, 2001 -------------------------------- ---------------------- **Signature of Reporting Person Date