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OMB Number: 3235-0287
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UNITED STATES 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 this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b)
(Print or Type Responses)
________________________________________________________________________________
1. Name and Address of Reporting Person*
McGuire Terrance
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(Last) (First) (Middle)
1000 Winter Street
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(Street)
Waltham, Massachusetts 02154
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(City) (State) (Zip)
deCODE genetics, Inc. ("DCGN")
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2. Issuer Name and Ticker or Trading Symbol
________________________________________________________________________________
3. I.R.S. Identification Number of Reporting Person, if an Entity (Voluntary)
July, 2000
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4. Statement for Month/Year
________________________________________________________________________________
5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Persons to Issuer
(Check all applicable)
[xx] Director [__] 10% Owner
[__] Officer (give title below) [__] Other (specify below)
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7. Individual or Joint/Group Filing (Check Applicable Line)
[xx] 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
2. 3. Disposed of (D) Securities Form: 7.
Transaction Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
Date Code ------------------------------- Owned at End (D) or Indirect
1. (Month/ (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Day/ ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) Year 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 7/21/00 C 1,582,854 A 1,582,854 I(1) Polaris
Venture
Partners,
L.P.
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Common Stock 7/21/00 C 92,161 A 92,161 I(1) Polaris
Venture
Partners
Founders'
Fund, L.P.
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Common Stock 7/17/00 P 3,000 A $18 3,000 D
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</TABLE>
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
4(b)(v).
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 CONTROL NUMBER.
(Over)
SEC 1474(3-99)
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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-
Derivate 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>
Polaris
Venture
Series A Common Partners,
Preferred 7/21/00 C 1,582,854 Immed -0- Stock 1,582,854 -0- I(1) L.P.
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Polaris
Venture
Partners
Founders'
Series A Common Fund,
Preferred 7/21/00 C 92,161 Immed -0- Stock 92,161 -0- I(1) L.P.
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Polaris
Venture
Common Partners,
Warrant (2) 10/30/97 8/26/05 Stock 189,496 $.01 189,496 I(1) L.P.
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Polaris
Venture
Partners
Founders'
Common Fund,
Warrant (2) 10/30/97 8/26/05 Stock 11,337 $.01 11,397 I(1) L.P.
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</TABLE>
Explanation of Responses:
(1) THE REPORTING PERSON IS A MEMBER OF POLARIS VENTURE MANAGEMENT CO,
L.L.C. WHICH IS THE GENERAL PARTNER OF POLARIS VENTURE PARTNERS, L.P.
AND POLARIS VENTURE PARTNERS FOUNDERS' FUND, L.P. THE REPORTING PERSON
DISCLAIMS BENEFICIAL OWNERSHIP OF THE REPORTED SECURITIES EXCEPT TO THE
EXTENT OF HIS PECUNIARY INTEREST THEREIN.
(2) UPON CLOSING OF ISSUER'S PUBLIC OFFERING ON JULY 21, 2000, THE WARRANTS
EXERCISABLE FOR SERIES A PREFERRED STOCK BECAME EXERCISABLE FOR COMMON
STOCK.
Terrance McGuire 8/9/00
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**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 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.
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