U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
[_] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Behrens Christopher C.
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(Last) (First) (Middle)
c/o Chase Capital Partners (FN 1)
1221 Avenue of the Americas-40th Floor
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(Street)
New York New York 10020
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Patina Oil & Gas Corporation ("POG")
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
December 1999
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5. If Amendment, Date of Original (Month/Year)
December 1999
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[_] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 3/15/99 J 728 A $3.4379 85,481 I By CVCA, LLC
(FN 1)
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Common Stock 6/15/99 J 396 A $6.3125 85,877 I By CVCA, LLC
(FN 1)
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Common Stock 9/15/99 J 290 A $8.625 86,167 I By CVCA, LLC
(FN 1)
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Common Stock 12/15/99 J 315 A $7.9375 86,482 I By CVCA, LLC
(FN 1)
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
(Over)
(Form 4-07/99)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Convertible Common PIK
Preferred $2.6316 J 104,888 Immed Stock 1,779,795 (FN 2) 676,317 I (FN 1)
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Non-Qualified Immed Common
Stock Option $2.9375 N/A A 5,000 (FN 3) 2/18/04 Stock 5,000 N/A 5,000 D(FN 3)
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10,000 I (FN 3)
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Non-Qualified Immed Common
Stock Option $5.1250 N/A A 5,000 (FN 3) 5/29/04 Stock 5,000 N/A 10,000 D(FN 3)
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10,000 I (FN 3)
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</TABLE>
Explanation of Responses:
(1) The amounts shown in Tables I and II represent the beneficial ownership
of the Issuer's equity securities by Chase Venture Capital Associates, LLC
("CVCA, LLC"), a portion of which may be attributable to the reporting person
because the reporting person is a general partner of Chase Capital Partners
("CCP"), which is the managing member of CVCA, LLC. The actual pro rata
portion of such beneficial ownership that may be deemed to be attributable to
the reporting person is not readily determinable because it is subject to
several variables, including CVCA, LLC's internal rate of return and vesting.
The reporting person disclaims beneficial ownership to the extent it exceeds
his pecuniary interest. Pursuant to an internal reorganization effective
as of January 1, 2000, (i) CVCA, LLC became the successor to Chase Venture
Capital Associates, LP ("CVCA, LP"), (ii) CCP-SBIC Manager, LLC, a newly
organized wholly-owned subsidiary of CCP, became the managing member of CVCA,
LLC, and (iii) CCP-CMC Consolidating, LLC ("Consolidating"), a newly-organized
affiliate of CCP, became the non-managing member of CVCA, LLC. CCP was the
managing member of Consolidating, and pursuant to a master advisory agreement
with CCP-SBIC Manager, LLC and Consolidating, the manager, by delegation, of
CVCA, LLC. Prior to the internal reorganization, the sole shareholder of
Consolidating was the limited partner of CVCA, LP. The internal reorganization
changed CVCA, LP's name and form of organization but did not alter the
proportionate interests of its ultimate security holders. As of March 13, 2000,
Consolidating was dissolved and the sole member of Consolidating, Chatham
Ventures, Inc., became the non-managing member of CVCA, LLC.
CCP remains the manager, by delegation, of CVCA, LLC.
(2) Dividends on Convertible Preferred Stock were payable in kind through
October 21, 1999.
(3) Stock option grant for non-employee directors issued pursuant to the 1996
Patina Non-Employee Stock Option Plan. Exercisable as follows: 30% on
first anniversary date of transaction, 30% on second anniversary date of
transaction, and 40% on third anniversary. The reporting person, a general
partner of CCP, is obligated to exercise each of the options upon the
request of CVCA, LLC and to transfer all shares received upon such
exercise and any shares awarded as director's compensation to CVCA, LLC.
/s/ Christopher C. Behrens 10/10/00
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Christopher C. Behrens 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.
