-----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, IfbanntZB9DAJzbez0ShuJmFkmfsoUNLa3X9gLaVsZ9AAxRA5mZCKrOJ+CP11cON Y9HMxO3+6nrLPB0p1eFw+w== 0001041885-02-000042.txt : 20020926 0001041885-02-000042.hdr.sgml : 20020926 20020926154729 ACCESSION NUMBER: 0001041885-02-000042 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020926 FILED AS OF DATE: 20020926 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BOSTON LIFE SCIENCES INC /DE CENTRAL INDEX KEY: 0000094784 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 870277826 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-06533 FILM NUMBER: 02773259 BUSINESS ADDRESS: STREET 1: 137 NEWBURY STREET STREET 2: 8TH FLOOR CITY: BOSTON STATE: MA ZIP: 02116 BUSINESS PHONE: 6174250200 MAIL ADDRESS: STREET 1: 137 NEWBURY STREET STREET 2: 8TH FLOOR CITY: BOSTON STATE: MA ZIP: 02116 FORMER COMPANY: FORMER CONFORMED NAME: STRATEGIC MEDICAL RESEARCH CORP /DE DATE OF NAME CHANGE: 19790521 FORMER COMPANY: FORMER CONFORMED NAME: GREENWICH PHARMACEUTICALS INC DATE OF NAME CHANGE: 19920703 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: GIPSON ROBERT L CENTRAL INDEX KEY: 0000904389 RELATIONSHIP: OTHER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O INGALLS & SNYDER STREET 2: 61 BROADWAY CITY: NEW YORK STATE: NY ZIP: 10006 BUSINESS PHONE: 2122697897 MAIL ADDRESS: STREET 1: C/O INGALLS & SNYDER LLC STREET 2: 61 BROADWAY CITY: NEW YORK STATE: NY ZIP: 10006 3 1 formthree92502corr.txt 3 1 NASDAQ CIK 0000904389 CCC #ksjuh9q 10% HOLDER NAME ED OBERST 212-269-7812 EOBERST@INGALLS.NET NAME BOSTON LIFE SCIENCES INC. CIK 0000094784 870277826 3 Initial State/Beneficial Ownership Of Securities ------------------------------ OMB APPROVAL ------------------------------ OMB Number Expires: Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(f) of the Investment Company Act of 1940 ================================================================================ 1. Name and Address of Reporting Person* GIPSON ROBERT L. - -------------------------------------------------------------------------------- (Last) (First) (Middle) C/O INGALLS & SNYDER LLC, 61 BROADWAY SUITE 3100 - -------------------------------------------------------------------------------- (Street) NEW YORK NEW YORK 10006 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) 07/25/02 ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ================================================================================ 4. Issuer Name and Ticker or Trading Symbol BOSTON LIFE SCIENCES INC. (BLSI) ================================================================================ 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ x ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) -------------------------------------------------------------------- ================================================================================ 6. If Amendment, Date of Original (Month/Year) ================================================================================ 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 Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr.5) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 254,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v) Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of ___ FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect 1. Title of Derivative Date Expira- Number Price of Indirect Beneficial Security (Instr. 4) Exer- tion of Derivative (I) Ownership cisable Date Title Shares Security (Instr.5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ SENIOR NOTES 7/26/02 6/1/05 COMMON ST 1,851,852 2.16 I NOTE 1 - ------------------------------------------------------------------------------------------------------------------------------------ WARRANTS 7/26/02 7/24/07 COMMON ST 500,000 2.16 I NOTE 1 - ------------------------------------------------------------------------------------------------------------------------------------ WARRANTS 2/26/02 3/1/07 COMMON ST 50,000 2.75 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: NOTE 1: Securities reported under indirect ownership are owned by Ingalls & Snyder Value Partners, L.P. ("ISVP"), an investment partnership managed under an Investment Advisory contract with Ingalls & Snyder LLC ("I&S"). Robert L. Gipson ("Gipson"), a Senior Director of I&S and Thomas O. Boucher, Jr., a Managing Director of I&S, are General Partners of ISVP and as such, share the power to vote the shares owned by it. ISVP owns a $4,000,000 convertible senior secured promissory note issued by BLSI which may be converted into 1,851,852 shares of BLSI common stock until 6/1/05. ISVP also owns 500,000 BLSI warrants. Each warrant gives ISVP the right to purchase one share of BLSI common stock for $2.16 until 7/24/07. Gipson's directly owned shareholdings, when added to the shares owned by ISVP, aggregate in excess of 10% of the outstanding adjusted common shares of Boston Life. Gipson disclaims beneficial ownership of ISVP shares in excess of his economic interest in ISVP. /s/ ROBERT L. GIPSON 9/25/02 - --------------------------------------------- ----------------------- **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. Alternatively, this form is permitted to be submitted to the Commission in electronic format at the option of the reporting person pursuant to Rule 101(b)(4) of Regulation S-T. Page 2 of __ (122795DTI) -----END PRIVACY-ENHANCED MESSAGE-----