-----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, E5z4sFgOJrjVqRzMZHKNL0hYWHRRDP26h4kzEcESXpwXn8jTEcD+RJSI61KmR008 02ZYpiZdaNhxjW68sa0GCw== 0000914121-02-000178.txt : 20020414 0000914121-02-000178.hdr.sgml : 20020414 ACCESSION NUMBER: 0000914121-02-000178 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020214 COMPANY DATA: COMPANY CONFORMED NAME: CHAPLIN DAVID CENTRAL INDEX KEY: 0001167232 OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 321 ARSENAL STREET CITY: WATERTOWN STATE: MA ZIP: 02472 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OXIGENE INC CENTRAL INDEX KEY: 0000908259 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 133679168 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-21990 FILM NUMBER: 02549619 BUSINESS ADDRESS: STREET 1: 321 ARSENAL STREET CITY: WATERTOWN STATE: MA ZIP: 02472 BUSINESS PHONE: 6176737800 5 1 ox634131v2-5.txt ANNUAL STATEMENT OF CHANGES - ------------------------- ------------------------------ FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB Approval - ------------------------- WASHINGTON, D.C. 20549 ------------------------------ [ ] Check box if no OMB Number: 3235-0362 longer subject to Expires: PENDING Section 16. Form 4 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden or Form 5 obligations hours per response.......1.0 may continue. See ------------------------------ Instruction 1(b). Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, [X] Form 3 Holdings Section 17(a) of the Public Utility Holding Company Act of 1935 or Reported Section 30(f) of the Investment Company Act of 1940 [X] Form 4 Transactions Reported
- ------------------------------------------------------------------------------------------------------------------------------------ 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) OXiGENE, Inc. Chaplin David c/o OXiGENE, Inc. "OXGN" [ ] Director [ ] 10% Owner --------------------------------------- ---------------------------------------------- [X] Officer (give [ ] Other (specify (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for title below) Number of Reporting Month/Year below) Person, if an entity (Voluntary) DECEMBER/2001 Head of Research and Development 321 Arsenal Street ------------------------------------ --------------------------------------- ------------------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Reporting Date of Original (Check Applicable Line) (Month/Year) [X] Form Filed by One Reporting Person Watertown, MA 02472 [ ] Form Filed by More than One --------------------------------------- Reporting Person (City) (State) (Zip) - ------------------------------------------------------------------------------------------------------------------------------------ TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial (Month/ Owned at end or Indirect Ownership Day/ of Issuer's (I) (Instr. 4) Year) Fiscal Year (Instr. 4) (Instr. 3 and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Amount (A) or (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 7/1/00 J(3)(*) 1,000 1,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ * If the form is filed by more than one reporting person, see Instruction 4(b)(v). Page 1 of 2 SEC 2270 (01-02)
FORM 5 (continued) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of of sion or action action Derivative Exer- and of of ship of Indirect Deriv- Exercise Date Code Securities cisable Amount Deriv- Deriv- Deriv- Beneficial ative Price of (Month/ (Instr. Acquired (A) and Expir- of ative ative ative Ownership Secu- Deriv- Day/ 8) or Disposed ation Under- Secu- Secu- Security: (Instr. 4) rity ative Year) of (D) Date lying rity rities Direct (Instr. Security (Instr. 3, (Month/ Securi- (Instr. Benefi- (D) or 3) 4, and 5) Day/ ties 5) cially Indirect Year) (Instr. Owned (I) 3 and 4) at end (Instr. of 4) Year (Instr. 4) ---------------------------------------------------- (A) (D) Date Expir- Title Amount Exercis- ation or able Date Number of Shares ----------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Com- Option (right 9.875 7/5/00 A4 45,000 7/5/01 7/5/10 mon 45,000 45,000 D to purchase) Stock - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Com- Option (right 5.06 7/12/00 A 45,000 7/12/02 7/12/11 mon 45,000 45,000 D to purchase) Stock - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: * Reporting person became an officer of the issuer on July 1, 2000. /s/ David Chaplin 02/14/02 ------------------------------------------ --------------------------- ** Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 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 control number. Page 2 of 2 SEC 2270 (01-02)
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