3 1 0001.txt FORM 3 [8-12-00]
------ ------------------------------- FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL ------ WASHINGTON, D.C. 20549 ------------------------------- OMB Number 3235-0104 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Expires: December 31, 2001 Estimated average burden Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, hours per response........0.5 Section 17(a) of the Public Utility Holding Company Act of 1935 ------------------------------- or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event 4. Issuer Name AND Ticker or Trading Symbol Requiring Statement Tepper Jerry J. (Month/Day/Year) Amerivest Properties, Inc. (AMV) 8/12/00 ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. IRS Identification 5. Relationship of Reporting 6. If Amendment, Date of Number of Reporting Person(s) to Issuer Original (Month/Day/Year) Person, if an entity (Check all applicable) (Voluntary) Director X 10% Owner --- --- 7255 N. Sheridan Officer Other ------------------------------------------ --- (give --- (specify --------------------------------- (Street) title) below) 7. Individual or Joint/Group below) Filing (Check Applicable Line) X Form filed by One Reporting ---Person -------------------------- Form filed by More than One Arvada CO 80003 ---Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial (Instr. 4) Beneficially Owned Form: Direct Ownership (Instr. 5) (Instr. 4) (D) or Indirect (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 10,000 D ------------------------------------------------------------------------------------------------------------------------------------ 300,000 I Held in corporation ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 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 5(b)(v). POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT (Over) REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. SEC 1473 (3-99)
FORM 3 (continued) TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Date Exercisable 3. Title and Amount of 4. Conversion 5. Ownership 6. Nature of (Instr. 4) and Expiration Date Securities Underlying or Exercise Form of Indirect (Month/Day/Year) Derivative Security Price of Derivative Beneficial (Instr. 4) Derivative Security: Ownership ------------------------------------------------- Security Direct (D) (Instr. 5) Date Exer- Expira- Amount or or cisable tion Title Number of Indirect (I) Date Shares (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants Immed. 7/10/05 Common 150,000 $5.00 I Held in Stock corporation ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: /s/Deborah J. Friedman 12/12/00 ** Intentional misstatements or omissions of facts ------------------------------------ ----------- constitute Federal Criminal Violations. Deborah J. Friedman Date See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Attorney-In-Fact 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 2