1
- --------- --------------------------- FORM 4 OMB APPROVAL - --------- U.S.SECURITIES AND EXCHANGE COMMISSION --------------------------- [ ] Check this box if no longer WASHINGTON, D.C. 20549 OMB Number 3235-0257 subject to Section 16. Form Expires: February 1, 2001 4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden continue. See Instruction 1(b). hours per response....1.0 --------------------------- 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| 2. Issuer Name and Ticker or Trading Symbol | 6. Relationship of Reporting Person | | to Issuer (Check all applicable) Sumner William | Halsey Drug Co., Inc. Symbol: HDGC | _X_ Director ___ 10% Owner - -------------------------------------------------------------------------------------------| ___ Officer (give ___ Other (specify (Last) (First) (Middle) | 3. IRS or Social | 4. Statement for | title below) | Security Number | Month/Year | below) C/o Halsey Drug Co., Inc. 695 N. | of Reporting | 02/01 | Perryville Rd. Bldg. 2 | Person (Voluntary) |-------------------------| - ---------------------------------------| | 5. If Amendment, | (Street) | | Date of Original | | | (Month/Year) | Rockford, Illinois 61107 | | | - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) | Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security | 2.Transaction | 3.Transaction | 4.Securities Acquired (A)|5. Amount of |6.Owner- | 7.Nature (Instr. 3) | Date | Code | or disposed of (D) | Securities| ship | of | | (Instr. 8) | (Instr. 3, 4, and 5) | Bene- | Form: | Indirect | (Month/Day/ | | | ficially | Direct | Bene- | Year) |---------------|--------------------------| Owned at | (D) or | ficial | | | | | | | End of | Indirect| Owner- | | | | | (A) | | Month | (I) | ship | | | | | or | | (Instr. 3 |(Instr.4)|(Instr.4) | | Code | V | Amount | (D) | Price | and 4) | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (over) (Print or Type Responses) SFC 1474 (3/91) *See footnote 2 on Table II 2 (1) Options vest 25% quarterly By: /s/ William Sumner March 2, 2001 ------------------ ------------- *Signature of Reporting Person 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.
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.Conversion | 3.Transaction | 4.Transaction | 5.Number of | 6.Date Exer- (Instr. 3) | or Exercise | Date | Code | Derivative | cisable and | Price of | | (Instr. 8) | Securities | Expiration Date | Derivative | (Month/Day/ | | Acquired (A) | (Month/Day/Year) | Security | Year) | | or Disposed | | | | | of (D) |------------------ | | | | (Instr. 3, | | | | | | 4, and 5) | Date | Expir- | | |---------------|--------------| Exer- | ation | | | Code | V | (A) | (D) | cisable | Date - ----------------------------------------------------------------------------------------------------------------- Non-qualified Stock Options | $2.375 | 2/19/98 | A | | | | (1) | 2/19/08 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.1875 | 2/19/99 | A | | | | (1) | 2/19/09 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.875 | 2/17/00 | A | | | | (1) | 2/17/10 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- Non-qualified Stock Options | $1.140 | 2/15/01 | A | | | | (1) | 2/15/11 - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------- | | | | | | | | - ------------------------------------------------------------------------------------------------- 7. Title and Amount | 8. Price of | 9. Number of | 10. Ownership | 11. Nature of of Underlying | Derivative | Derivative | Form of | Indirect Securities | Security | Securities | Derivative | Beneficial (Instr. 3 and 4) | (Instr. 5) | Beneficially| Security; | Ownership | | Owned at End| Direct (D) or| (Instr. 4) - ----------------------------| | of Month | Indirect (I) | | | | (Instr. 4) | (Instr. 4) | | Amount or | | | | | Number of | | | | Title | Shares | | | | - ------------------------------------------------------------------------------------------------- Common Stock | 10,000 | | 10,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 10,000 | | 20,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 10,000 | | 30,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- Common Stock | 10,000 | | 40,000 | D | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | | - ---------------|------------|---------------|----------------|-------------------|--------------- | | | | |