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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who 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. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Option | $ 11.63 | 11/19/2004 | D | 12,000 | (2) | 05/02/2006 | Common Stock | 12,000 | (2) | 0 | D | ||||
Stock Option | $ 9.265 | 11/19/2004 | D | 10,000 | (3) | 11/18/2006 | Common Stock | 10,000 | (3) | 0 | D | ||||
Stock Option | $ 9.935 | 11/19/2004 | D | 4,000 | (4) | 04/26/2009 | Common Stock | 4,000 | (4) | 0 | D | ||||
Stock Option | $ 9 | 11/19/2004 | D | 4,000 | (5) | 05/09/2010 | Common Stock | 4,000 | (5) | 0 | D | ||||
Stock Option | $ 10.125 | 11/19/2004 | D | 700 | (6) | 08/07/2010 | Common Stock | 700 | (6) | 0 | D | ||||
Stock Option | $ 18.25 | 11/19/2004 | D | 700 | (7) | 11/21/2010 | Common Stock | 700 | (7) | 0 | D | ||||
Stock Option | $ 22.375 | 11/19/2004 | D | 700 | (8) | 02/01/2011 | Common Stock | 700 | (8) | 0 | D | ||||
Stock Option | $ 17 | 11/19/2004 | D | 4,700 | (9) | 05/01/2011 | Common Stock | 4,700 | (9) | 0 | D | ||||
Stock Option | $ 25.61 | 11/19/2004 | D | 700 | (10) | 08/01/2011 | Common Stock | 700 | (10) | 0 | D | ||||
Stock Option | $ 26.14 | 11/19/2004 | D | 700 | (11) | 11/01/2011 | Common Stock | 700 | (11) | 0 | D | ||||
Stock Option | $ 25.34 | 11/19/2004 | D | 8,000 | (12) | 11/05/2011 | Common Stock | 8,000 | (12) | 0 | D | ||||
Stock Option | $ 22.99 | 11/19/2004 | D | 700 | (13) | 02/01/2012 | Common Stock | 700 | (13) | 0 | D | ||||
Stock Option | $ 23.19 | 11/19/2004 | D | 4,700 | (14) | 05/01/2012 | Common Stock | 4,700 | (14) | 0 | D | ||||
Stock Option | $ 16.46 | 11/19/2004 | D | 700 | (15) | 08/01/2012 | Common Stock | 700 | (15) | 0 | D | ||||
Stock Option | $ 16.52 | 11/19/2004 | D | 700 | (16) | 11/18/2012 | Common Stock | 700 | (16) | 0 | D | ||||
Stock Option | $ 10.53 | 11/19/2004 | D | 700 | (17) | 02/07/2013 | Common Stock | 700 | (17) | 0 | D | ||||
Stock Option | $ 16.47 | 11/19/2004 | D | 12,000 | (18) | 04/28/2013 | Common Stock | 12,000 | (18) | 0 | D | ||||
Stock Option | $ 31.34 | 11/19/2004 | D | 15,000 | (19) | 05/03/2014 | Common Stock | 15,000 | (19) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
O CONNOR C RODNEY 2579 MIDPOINT DRIVE FORT COLLINS, CO 80525 |
X |
Sarah Watson, Attorney-in-Fact for C. Rodney O'Connor | 11/23/2004 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Disposed of pursuant to merger agreement between issuer and QLT Inc. for 73,000 shares of QLT common stock having a market value of $15.42 per share as reported on NASDAQ on the effective date of the merger, and $1,066,530.00 in cash. |
(2) | This option, which provided for vesting in three equal annual installments beginning on May 3, 1997, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 22,848 shares of QLT Inc. common stock for $6.11 per share. |
(3) | This option, which provided for vesting in three equal annual installments beginning on November 18, 1997, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 19,040 shares of QLT Inc. common stock for $5.06 per share. |
(4) | This option, which provided for vesting in three equal annual installments beginning on April 26, 2000, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 7,616 shares of QLT Inc. common stock for $5.22 per share. |
(5) | This option, which provided for vesting in three equal annual installments beginning on May 9, 2001, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 7,616 shares of QLT Inc. common stock for $4.73 per share. |
(6) | This option, which provided for vesting in three equal annual installments beginning on August 7, 2001, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $5.32 per share. |
(7) | This option, which provided for vesting in three equal annual installments beginning on November 21, 2001, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $9.59 per share. |
(8) | This option, which provided for vesting in three equal annual installments beginning on May 1, 2002, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $11.76 per share. |
(9) | This option, which provided for vesting in three equal annual installments beginning on May 1, 2002, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 8,948 shares of QLT Inc. common stock for $8.93 per share. |
(10) | This option, which provided for vesting in three equal annual installments beginning on August 1, 2002, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $13.46 per share. |
(11) | This option, which provided for vesting in three equal annual installments beginning on November 1, 2002, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $13.73 per share. |
(12) | This option, which provided for vesting in three equal annual installments beginning on November 5, 2002, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 15,232 shares of QLT Inc. common stock for $13.31 per share. |
(13) | This option, which provided for vesting in three equal annual installments beginning on February 1, 2003, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $12.08 per share. |
(14) | This option, which provided for vesting in three equal annual installments beginning on May 1, 2003, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 8,949 shares of QLT Inc. common stock for $12.18 per share. |
(15) | This option, which provided for vesting in three equal annual installments beginning on August 1, 2003, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $8.65 per share. |
(16) | This option, which provided for vesting in three equal annual installments beginning on November 18, 2003, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $8.68 per share. |
(17) | This option, which provided for vesting in three equal annual installments beginning on February 7, 2004, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 1,332 shares of QLT Inc. common stock for $5.54 per share. |
(18) | This option, which provided for vesting in three equal annual installments beginning on April 28, 2004, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 22,848 shares of QLT Inc. common stock for $8.65 per share. |
(19) | This option, which provided for vesting in three equal annual installments beginning on May 3, 2005, was assumed by QLT Inc. in the merger and replaced with a fully vested option to purchase 28,561 shares of QLT Inc. common stock for $16.46 per share. |