-----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, AUcemt8phuv/UPXzoDNquf+6LxABZff7CTxey267J/7tp+phR/MW2uMpLtsE0s/q uheBKVPG6I9kPTqX+eBlAg== 0000912057-01-516172.txt : 20010516 0000912057-01-516172.hdr.sgml : 20010516 ACCESSION NUMBER: 0000912057-01-516172 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010331 FILED AS OF DATE: 20010515 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: IGEN INTERNATIONAL INC /DE CENTRAL INDEX KEY: 0000916304 STANDARD INDUSTRIAL CLASSIFICATION: PATENT OWNERS & LESSORS [6794] IRS NUMBER: 942852543 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-23252 FILM NUMBER: 1639601 BUSINESS ADDRESS: STREET 1: 16020 INDUSTRIAL DR CITY: GAITHERSBURG STATE: MD ZIP: 20877 BUSINESS PHONE: 3019848000 MAIL ADDRESS: STREET 1: 16020 INDUSTRIAL DRIVE CITY: GAITHERSBURG STATE: MD ZIP: 20877 FORMER COMPANY: FORMER CONFORMED NAME: IGEN INC /CA/ DATE OF NAME CHANGE: 19931216 COMPANY DATA: COMPANY CONFORMED NAME: MIGAUSKY GEORGE V CENTRAL INDEX KEY: 0001134365 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 16020 INDUSTRIAL DR CITY: GAITHERSBURG STATE: MD ZIP: 20877 BUSINESS PHONE: 3018699800 MAIL ADDRESS: STREET 1: IGEN INTERNATIONAL INC STREET 2: 16020 INDUSTRIAL DR CITY: GAITHERSBURG STATE: MD ZIP: 20877 5 1 a2048275z5.txt FORM 5 - -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 5 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ----------------------------- / / CHECK BOX IF NO LONGER ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0362 SUBJECT TO SECTION 16. ESTIMATED AVERAGE BURDEN FORM 5 OBLIGATIONS Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, HOURS PER RESPONSE .... 1.0 MAY CONTINUE. SEE Section 17(a) of the Public Utility Holding Company Act of 1935 or ----------------------------- INSTRUCTION 1(b). Section 30(f) of the Investment Company Act of 1940 / / FORM 3 HOLDINGS REPORTED / / FORM 4 TRANSACTIONS REPORTED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to Issuer (Check all applicable) Director 10% Owner Migausky George V. IGEN International, Inc. (IGEN) ---- ---- - ------------------------------------------------------------------------------------------- X Officer Other (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---- Number of Reporting Month/Year (give title below) (specify below) Person (Voluntary) Vice President and 16020 Industrial Drive 3/31/01 Chief Financial Officer - ------------------------------------------- ------------------------------------------------------------- (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 --- Form filed by More than One Reporting Person --- Gaithersburg Maryland 20877 - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) or 5. Amount of 6. Owner- 7. Nature of (Instr. 3) action tion Disposed of (D) Securities ship Indirect Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial (Month/ (Instr. 8) Owned at Direct Ownership Day/ End of (D) or (I) (Instr. 4) Year) Issuer's Indirect Fiscal Year (Instr. 4) ------------------------------ (Instr. 3 Amount (A) or (D) Price and 4) - ------------------------------------------------------------------------------------------------------------------------------------ None - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) *If the form is filed by more than one reporting person, see Instruction 4(b)(v). (Print or Type Responses)
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 6. Date Exer- (Instr. 3) sion of action action Derivative cisable and Exercise Date Code Securities Expiration Price of (Month/ (Instr. 8) Acquired (A) or Date Deriv- Day/ Disposed of (D) Month/Day/ ative Year) (Instr. 3, 4, and 5) Year) Security -------------------- ---------------------- Date Expir- Exer- ation (A) (D) cisable Date - ------------------------------------------------------------------------------------------------------------------------ Option to Buy (1) $18.75 8/1/00 A 25,000 8/1/00 (1) 8/1/2010 - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - --------------------------------------------------------------------------------------------------- 7. Title and Amount of Under- 8. Price of 9. Number 10. Ownership 11. Nature of lying Securities Derivative of Derivative of Derivative Indirect (Instr. 3 and 4) Security Securities Security Beneficial (Instr. 5) Beneficially Direct (D) or Ownership Owned at End Indirect (I) (Instr. 4) of Year (Instr. 4) (Instr. 4) - ------------------------------------ Amount or Title Number of Shares - --------------------------------------------------------------------------------------------------- Common Stock 25,000 25,000 D - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------- Explanation of Responses: (1) Employee option granted under the Issuer's 1994 Stock Option Plan. Option vests 20% one year from the grant date and then an additional 5% vest each quarter thereafter. Option also has early exercise feature that allows immediate exercise subject to a limited repurchase right in favor of the Issuer. /s/ George V. Migausky 5/14/01 ----------------------------------- ----------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date 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.
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