4 1 form-4.txt -------------------------------- OMB APPROVAL -------------------------------- OMB Number: 3235-0287 Expires: December 31, 2005 Estimated average burden hours per response ..............0.5 -------------------------------- U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 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(h) of the Investment Company Act of 1940 [X] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ________________________________________________________________________________ 1. Name and Address of Reporting Person* Kimberlin Kevin B. -------------------------------------------------------------------------------- (Last) (First) (Middle) 535 Madison Avenue, 18th Floor -------------------------------------------------------------------------------- (Street) New York NY 10022 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol The Immune Response Corporation ________________________________________________________________________________ 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year July 2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable Line) [X] Form filed by one Reporting Person [_] Form filed by More than One Reporting Person ________________________________________________________________________________ 1 ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
1. Title of Security 2. 3. 4. 5. 6. 7. (Instr. 3) Transaction Transaction Securities Acquired (A) or Amount of Owner- Nature of Date Code Disposed of (D) Securities ship Indirect (mm/dd/yy) (Instr. 8) (Instr. 3, 4 and 5) Beneficially Form: Beneficial ----------- ------------------------------- Owned at End Direct Ownership of Month (D) or (Instr. 4) (A) (Instr. 3 Indirect Amount or Price and 4) (I) Code V (D) (Instr.4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $.0025 per share 35,000 I See Note (1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $.0025 per share 16,000 I See Note (2) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $.0025 per share 227,916 I See Note (3) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $.0025 per share See Note (4) 1,794,871 I See Note (4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 1. Held by the reporting person's spouse. 2. Held in a retirement account for the benefit of the reporting person. 3. Held by Kimberlin Family Partners L.P. a Colorado limited partnership, of which the reporting person is the general partner. 4. The reported securities were included in Units, each of which included one share of the Issuer's common stock and one warrant to purchase one share of the Issuer's common stock (which warrants have subsequently expired), purchased in 1997 for $7.80 per Unit by Kevin Kimberlin Partners, L.P., a Delaware limited partnership, of which the general partner is KKP Management LLC, a Nevada limited liability company, of which the reporting person is the managing member. ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. SEC 1474 (3-99) *If the form is filed by more than one reporting person, see Instruction 4(b)(v).
2 FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Title of Conver- Trans- Trans- Number of Date Title and Amount Price Number Owner- Nature Derivative sion action action Derivative Exercisable and of Underlying of of ship of Security or Date Code Securities Expiration Date Securities Deriv- deriva- Form In- (Instr. 3) Exer- (Month/ (Instr. Acquired (A) (Month/Day/Year) (Instr. 3 and 4) ative ative of direct cise Day/ 8) or Disposed ---------------- ---------------- Secur- Secur- Deriv- Bene- Price Year) ------- of (D) ity ities- ative ficial of (Instr. 3, (Instr. Bene- Secur- Owner- Deriv- 4 and 5) 5) ficially ity: ship ative ------------ Owned Direct (Instr. Secur- at End (D) or 4) ity Amount of In- or Month direct Date Expira- Number (Instr. (I) Exer- tion of 4) (Instr. Code V (A) (D) cisable Date Title Shares 4) ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $18.25 12/15/92 A Immed. 12/15/02 Stock 25,000 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $8.00 9/19/94 A Immed. 9/19/04 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $5.44 6/14/95 A Immed. 6/14/05 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $12.25 5/30/96 A Immed. 5/30/06 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $8.75 5/22/97 A Immed. 5/22/07 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $13.69 6/11/98 A Immed. 6/11/08 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $7.3125 5/25/99 A Immed. 5/25/09 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $5.78125 8/17/99 A Immed. 8/17/09 Stock 4,719 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $5.9380 5/25/00 A Immed. 5/25/10 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $3.9380 11/27/00 A Immed. 11/27/10 Stock 29,367 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy See Note Common Common Stock $3.9380 11/14/00 A (5) 11/14/10 Stock 70,638 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $3.450 6/21/01 A 6/22/02 6/21/11 Stock 6,250 D ------------------------------------------------------------------------------------------------------------------------------------ Option to buy Common Common Stock $0.59 6/17/02 A 6/17/03 6/17/12 Stock 6,250 155,424 D ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible Debenture Common See due 2004 $1.1536 11/9/01 P 1,733,703 Immed. 11/09/04 Stock 1,733,703 I Note (6) ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy Common See Common Stock $1.4420 11/9/01 P 1,733,703 Immed. 11/09/11 Stock 1,733,703 3,467,406 I Note (6) ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible Debenture Common See due 2005 $1.036 02/14/02 P 1,716,001 Immed. 02/14/05 Stock 1,716,001 I Note (7) ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy Common See Common Stock $1.1655 02/14/02 P 1,716,001 Immed. 02/14/12 Stock 1,716,001 3,432,002 I Note (7) ------------------------------------------------------------------------------------------------------------------------------------
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1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Title of Conver- Trans- Trans- Number of Date Title and Amount Price Number Owner- Nature Derivative sion action action Derivative Exercisable and of Underlying of of ship of Security or Date Code Securities Expiration Date Securities Deriv- deriva- Form In- (Instr. 3) Exer- (Month/ (Instr. Acquired (A) (Month/Day/Year) (Instr. 3 and 4) ative ative of direct cise Day/ 8) or Disposed ---------------- ---------------- Secur- Secur- Deriv- Bene- Price Year) ------- of (D) ity ities- ative ficial of (Instr. 3, (Instr. Bene- Secur- Owner- Deriv- 4 and 5) 5) ficially ity: ship ative ------------ Owned Direct (Instr. Secur- at End (D) or 4) ity Amount of In- or Month direct Date Expira- Number (Instr. (I) Exer- tion of 4) (Instr. Code V (A) (D) cisable Date Title Shares 4) ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible See Debenture Common Notes due 2005 $0.432 05/03/02 P 9,276,437 Immed. 05/13/05 Stock 9,276,437 I (8)(12) ------------------------------------------------------------------------------------------------------------------------------------ See Warrant to buy Common Notes Common Stock $0.54 05/03/02 P 9,276,437 Immed. 05/03/12 Stock 9,276,437 18,552,874 I (8)(12) ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible See Debenture Common Notes due 2005 $0.4776 06/24/02 P 2,093,802 Immed. 06/24/05 Stock 2,093,802 I (9)(12) ------------------------------------------------------------------------------------------------------------------------------------ See Warrant to buy Common Notes Common Stock $0.597 06/24/02 P 2,093,802 Immed. 06/24/12 Stock 2,093,802 4,187,604 I (9)(12) ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible See Debenture Common Notes due 2005 $0.3992 07/11/02 P 1,419,433 Immed. 07/11/05 Stock 1,419,433 $566,638 I (10)(12) ------------------------------------------------------------------------------------------------------------------------------------ See Warrant to buy Common Notes Common Stock $0.499 07/11/02 P 1,419,433 Immed. 07/11/12 Stock 1,419,433 2,838,866 I (10)(12) ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible See Debenture Common Notes due 2005 $0.3704 07/30/02 P 1,720,272 Immed. 07/30/05 Stock 1,720,272 $637,189 I (11)(12) ------------------------------------------------------------------------------------------------------------------------------------ See Warrant to buy Common Notes Common Stock $0.4634 07/30/02 P 1,720,272 Immed. 07/30/12 Stock 1,720,272 3,440,544 I (11)(12) ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (5) An equal portion of the options to purchase 70,638 shares of the Issuer's common stock, which were granted to the reporting person on November 14, 2000, vest each day that the reporting person remains a member of the Issuer's board of directors, with the entire grant to become fully vested on January 1, 2003. (6) On November 9, 2001, Kevin Kimberlin Partners, L.P., a Delaware limited partnership, of which the general partner is KKP Management LLC, a Nevada limited liability company, of which the reporting person is the managing member, purchased (a) a promissory note initially convertible into 1,733,703 shares of the Issuer's common stock and (b) a warrant to purchase 1,733,703 shares of the Issuer's common stock. (7) On February 14, 2002, Oshkim Limited Partnership, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 1,716,001 shares of the Issuer's common stock and (b) a warrant to purchase 1,716,001 shares of the Issuer's common stock. (8) On May 3, 2002, Oshkim Limited Partnership, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 9,276,437 shares of the Issuer's common stock and (b) a warrant to purchase 9,276,437 shares of the Issuer's common stock. 4 (9) On June 24, 2002, Oshkim Limited Partnership, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 2,093,802 shares of the Issuer's common stock and (b) a warrant to purchase 2,093,802 shares of the Issuer's common stock. The promissory note is alternatively convertible (at the option of the reporting person and subject to the receipt of all necessary corporate and regulatory approvals) into 10 units (rather than the Issuer's common stock) to be sold by the Issuer as part of a contemplated private offering of units comprised of the Issuer's common stock and warrants. (10) On July 11, 2002, The Kimberlin Family 1998 Irrevocable Trust, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 1,419,433 shares of the Issuer's common stock and (b) a warrant to purchase 1,419,433 shares of the Issuer's common stock. The promissory note is alternatively convertible (at the option of the reporting person and subject to the receipt of all necessary corporate and regulatory approvals) into units (at a price of $100,000 per unit) to be sold by the Issuer as part of a contemplated private offering of units comprised of the Issuer's common stock and warrants. (11) On July 30, 2002, The Kimberlin Family 1998 Irrevocable Trust, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 1,720,272 shares of the Issuer's common stock and (b) a warrant to purchase 1,720,272 shares of the Issuer's common stock. $433,362 of the promissory note is alternatively convertible (at the option of the reporting person and subject to the receipt of all necessary corporate and regulatory approvals) into units (at a price of $100,000 per unit) to be sold by the Issuer as part of a contemplated private offering of units comprised of the Issuer's common stock and warrants. (12) Pursuant to a Letter Agreement, dated as of August 8, 2002, by and between the Issuer, Oshkim Limited Partnership and The Kimberlin Family 1998 Irrevocable Trust, neither Oshkim nor the Trust may without the prior written consent of the Issuer, vote or sell any shares of the Issuer's common stock issuable upon the conversion or the exercise of any promissory note or warrant issued in May, June and July 2002 until the Issuer obtains stockholder approval of such issuances of notes and warrants for purposes of compliance with certain NASD rules. ================================================================================ /s/ KEVIN B. KIMBERLIN August 12, 2002 --------------------------------------------- ----------------------- Kevin B. Kimberlin Date ** 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 currently valid OMB control number. 5