-----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, VKGuJEOve+KB9HrWeZHyCpymwlZBPzJtSmJbb4WvsNMms+BSvBWvagocI1jw2dZv G/u/of6WMjt3A2YIXkGSBg== 0000898432-02-000806.txt : 20021115 0000898432-02-000806.hdr.sgml : 20021115 20021114175507 ACCESSION NUMBER: 0000898432-02-000806 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021104 FILED AS OF DATE: 20021115 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: KIMBERLIN KEVIN CENTRAL INDEX KEY: 0000904841 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: SPENCER TRASK SECURITIES INC STREET 2: 535 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2123555565 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: 1934 Act SEC FILE NUMBER: 000-18006 FILM NUMBER: 02826812 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 4 1 kimberlin_form4.txt ---------------------------- OMB APPROVAL ---------------------------- OMB Number: 3235-0287 Expires: January 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 [_] Check this 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 NOVEMBER 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 ________________________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. 2A. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 1. 2. Deemed Code ------------------------------- Owned at End (D) or Indirect Title of Transaction Execution (Instr. 8) (A) of Month Indirect Beneficial Security Date Date, if any ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock par value See $.0025 per share 8,750 I Note (1) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock par value See $.0025 per share 4,000 I Note (2) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock par value See $.0025 per share 56,979 I Note (3) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock See par value Note See $.0025 per share (4) 448,717 I Note (4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
(Over) (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 genral 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 partnerhsip, 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. * If the Form is filed by more than one reporting person, see Instruction 4(b)(v). Page 1 of 4 FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form 2. deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or 3A Derivative 6. of Underlying 8. ities Secur- of Exer- Deem- 4. Securities Date Securities Price Bene- ity: In- cise 3. ed Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date, Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date if any Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr (Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $73.00 12/15/92 A Immed. 12/15/02 Common 6,250 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $32.00 9/19/94 A Immed. 9/19/04 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $21.76 6/14/95 A Immed. 6/14/05 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $49.00 5/30/96 A Immed. 5/30/06 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $35.00 5/22/97 A Immed. 5/22/07 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $54.76 6/11/98 A Immed. 6/11/08 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $29.25 5/25/99 A Immed. 5/25/09 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $23.125 8/17/99 A Immed. 8/17/09 Common 1,180 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $23.752 5/25/00 A Immed. 5/25/10 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $15.752 11/27/00 A Immed. 11/27/10 Common 7,341 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Page 2 of 4 10. 9. Owner- Number ship of Form 2. deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or 3A Derivative 6. of Underlying 8. ities Secur- of Exer- Deem- 4. Securities Date Securities Price Bene- ity: In- cise 3. ed Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date, Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date if any Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr (Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $15.752 11/14/00 A See Note 11/14/10 Common 17,659 D Common Stock (5) Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $13.80 6/21/01 A 6/22/02 6/21/11 Common 1,563 D Common Stock Stock - ------------------------------------------------------------------------------------------------------------------------------------ Option to buy $2.36 6/17/02 A 6/17/03 6/17/12 Common 1,563 39,050 D Common Stock (5) Stock - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $4.6144 11/9/01 P 433,426 Immed. Common 433,426 I See Debenture due Stock Note 2004 (6) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $5.768 11/9/01 P 433,426 Immed. 11/9/11 Common 433,426 866,851 I See Common Stock Stock Note (6) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $4.144 02/14/02 P 429,000 Immed. Common 429,000 I See Debenture due Stock Note 2005 (7) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $4.662 02/14/02 P 429,000 Immed. 02/14/12 Common 429,000 858,000 I See Common Stock Stock Note (7) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $1.728 05/03/02 P 2,319,109 Immed. Common 2,319,109 I See Debenture due Stock Note 2005 (8) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $2.16 05/03/02 P 2,319,109 Immed. Common 2,319,109 4,638,218 I See Common Stock Stock Note (8) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $1.9104 06/24/02 P 523,451 Immed. Common 523,451 I See Debenture due Stock Note 2005 (9) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $2.388 06/24/02 P 523,451 Immed. 06/24/12 Common 523,451 1,046,901 I See Common Stock Stock Note (9) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $1.5968 07/11/02 P 354,858 Immed. 07/11/05 Common 354,858 I See Debenture due Stock Note 2005 (10) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $1.996 07/11/02 P 354,858 Immed. 07/11/12 Common 354,858 709,716 I See Common Stock Stock Note (10) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $1.1852 07/30/02 P 430,068 Immed. 07/30/05 Common 430,068 $637,189 I See Debenture due Stock Note 2005 (11) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $1.4816 07/30/02 P 430,068 Immed. 07/30/12 Common 430,068 860,136 I See Common Stock Stock Note (11) - ------------------------------------------------------------------------------------------------------------------------------------ Page 3 of 4 10. 9. Owner- Number ship of Form 2. deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or 3A Derivative 6. of Underlying 8. ities Secur- of Exer- Deem- 4. Securities Date Securities Price Bene- ity: In- cise 3. ed Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date, Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date if any Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr (Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ 8% Convertible $1.1424 11/12/02 P 4,243,354 Immed. 11/12/05 Common $4,847,607 I See Debenture due Stock Note 2005 (12) - ------------------------------------------------------------------------------------------------------------------------------------ Warrant to buy $1.428 11/12/02 P 4,243,354 Immed. 11/12/12 Common 8,486,708 I See Common Stock Stock Note (12) - ------------------------------------------------------------------------------------------------------------------------------------ (5) An equal portion of the options to purchase 17,659 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 433,425 shares of the Issuer's common stock and (b) a warrant to purchase 433,425 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 429,000 shares of the Issuer's common stock and (b) a warrant to purchase 429,000 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 2,319,109 shares of the Issuer's common stock and (b) a warrant to purchase 2,319,109 shares of the Issuer's common stock. (9) On June 24, 2002, Oshkim Limited Partnership, of which the reporting person is an affiliate, purchased (a) a promissory note initially convertible into 523,450 shares of the Issuer's common stock and (b) a warrant to purchase 523,450 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 354,858 shares of the Issuer's common stock and (b) a warrant to purchase 354,858 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 537,621 shares of the Issuer's common stock and (b) a warrant to purchase 537,621 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) On November 12, 2002, Cheshire Associates LLC, of which the reporting person is a related party, purchased (a) a promissory note initially convertible into 4,243,354 shares of the Issuer's common stock and (b) a warrant to purchase 4,243,354 shares of the Issuer's common stock. THE NUMBER OF SHARE AND PRICE PER SHARE AMOUNTS SET FORTH IN THIS FORM HAVE BEEN CALCULATED TO TAKE INTO ACCOUNT THE EFFECTS OF THE 1 FOR 4 REVERSE STOCK SPLIT EFFECTED ON OR ABOUT OCTOBER 9, 2002 BY THE ISSUER. - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Kevin B. Kimberlin November 14, 2002 - --------------------------------------------- ----------------------- **Signature of Reporting Person 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 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 4 of 4 -----END PRIVACY-ENHANCED MESSAGE-----