4 1 a2037749z4.txt 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: DECEMBER 31, 2001 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) IGEN INTERNATIONAL, INC. (IGEN) to Issuer (Check all applicable) MIGAUSKY GEORGE V. Director 10% Owner ---- ---- --------------------------------------------------------------------------------------------- X Officer (give Other (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify Number of Reporting Month/Year below) below c/o IGEN INTERNATIONAL, INC. Person (Voluntary) JANUARY 2001 CHIEF FINANCIAL OFFICER 16020 INDUSTRIAL DRIVE -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original X Form filed by One Reporting Person (Month/Year) --- Form filed by More than One GAITHERSBURY MD 20877 ---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 Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4) and 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/02/01 M 4,000 A .571428 27,800 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/02/01 G 1,333 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/02/01 G 1,334 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/02/01 G 1,333 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/02/01 G 1,333 A 35,200 I (1) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ *If the Form is filed by more than one reporting person SEE Instruction 4(b)(v). (Over) SEC 1474 (7-96)
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) ------------------------------------------------------------------------------------------------------------------------ Option to Buy $0.57 01/02/01 M 4,000 (2) 5/21/01 ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ 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 4,000 0 D ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------ Explanation of Responses: (1) Includes 11,733 shares held by Reporting Person as Custodian under Uniform Gift to Minors Act for Kara Migausky, a minor child and 23,467 shares held by adult children who share the reporting person's household. Reporting person disclaims beneficial ownership of all securities held by adult children, and this report should not be deemed an admission that reporting person is beneficial owner of these shares for purposes of Section 16 or for any other purpose. (2) 20% of the option may be exercised one year from the date of the grant (5/21/91) and an additional 5% of the option may be exercised each quarter thereafter. /s/ George V. Migausky 2/8/01 ----------------------------------- ----------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date Federal Criminal Violations. George V. Miguasky 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)