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------ U.S. SECURITIES AND EXCHANGE COMMISSION ------------------------------
FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
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STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287
[ ] Check this box if no Expires: December 31, 2001
longer subject to Filed pursuant to Section 16(a) of the Securities Estimated average burden
Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the hours per response.........0.5
or Form 5 obligations Public Utility Holding Company Act of 1935 ------------------------------
may continue. See or Section 30(f) of the Investment Company
Instruction 1(b). Act of 1940
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Savoy William D. Drugstore.com (DSCM) Issuer (Check all applicable)
--------------------------------------------- ---------------------------------------------- X Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
110 - 130th Avenue N.E., Suite 550 Number of Reporting Month/Year Officer (give Other (specify
--------------------------------------------- Person (Voluntary) August 2000 ---- title --- below)
(Street) ------------------ below)
Bellevue Washington 98004 5. If Amendment,
--------------------------------------------- -------------------------- Date of Original --------------------------------
(City) (State) (Zip) (Month/Year)
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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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Instr. 8) End of Month Direct Benefi-
(Month/ (Instr. 3 and 4) (D) or cial
Day/ --------------------------------------- Indirect Owner-
Year) Code V Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr. 4)
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*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)
SEC 1474 (8-92)
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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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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv-
Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative
Deriv- Day/ Disposed of (D) (Month/Day/ Secur-
ative Year) (Instr. 3, 4, Year) ity
Security and 5) (Instr. 5)
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Code V (A) (D) Date Expira- Title Amount or
Exer- tion Number of
cisable Date Shares
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Series A Preferred Stock 1:100 8/4/00 P 5,433.57 (3) Common 543,357 $491.75
Stock
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9. Number of 10. Ownership 11. Nature of
Derivative Form of Indirect
Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at End Direct (D) (Instr. 4)
of Month or Indirect (I)
(Instr. 4) (Instr. 4)
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5,433.57 (1) (2)
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Explanation of Responses:
(1) Owned directly by Vulcan Ventures Incorporated ("VVI") and indirectly by Paul G. Allen,
the sole shareholder of VVI.
(2) Mr. Savoy is an Advisor at Vulcan Ventures, Inc., and Director at Drugstore.com.
Mr. Savoy disclaims beneficial ownership of shares held by Vulcan Ventures, Inc.,
except to the extent of his pecuniary interest therein.
(3) Shall convert into Common Stock upon shareholder vote to occur no later than 11/4/2000.
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ WILLIAM D. SAVOY Sept. 8, 2000
Note: File three copies of this Form, one of which must be manually signed. ------------------------------- ---------------
If space provided is insufficient, see Instruction 6 for procedure. **Signature of Reporting Person Date
William D. Savoy
SEC 1474 (8-92)
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