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FORM 4
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[X] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Lillian Trust
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(Last) (First) (Middle)
c/o Unsworth & Associates
Herengracht 483
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(Street)
1017 BT, Amsterdam, The Netherlands
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Balanced Care Corporation (Symbol: BAL)
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3. IRS or Social Security Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Year
September 2000
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[_] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check Applicable Line)
[_] Form filed by One Reporting Person
[X] Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
<TABLE>
<CAPTION>
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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) (Month/Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Common Stock 9/13/00 P 932,400 A 1.00 18,093,300 I (1)
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Common Stock 9/26/00 P 10,100 A .9833 18,093,300 I (1)
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Common Stock 9/27/00 P 8,300 A 1.00 18,093,300 I (1)
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Common Stock 9/28/00 P 87,500 A 1.00 18,093,300 I (1)
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Common Stock 9/29/00 P 15,000 A 1.00 18,093,300 I (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.
(Over)
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(Print of Type Responses)
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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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>
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</TABLE>
Explanation of Responses:
Note 1: These shares are owned directly by IPC Advisors S.A.R.L. These shares
may be deemed to be owned indirectly by LXB Investments Limited as the
sole shareholder of IPC Advisors S.A.R.L., by the Lillian Trust, as the
sole shareholder of LXB Investments Limited, and by the Monument Trust
Company Limited, as the trustee of the Lillian Trust.
** 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.
The Monument Trust Company Limited,
as Trustee of the Lillian Trust
/s/ S. R. HENNING 10/10/00
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**Signature of Reporting Person Date
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