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FORM 5 OMB APPROVAL
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----- Check this box if no longer OMB Number:..................
subject to Section 16. Form 4 Expires:.....................
----- or Form 5 obligations may Estimated average burden
continue. See Instruction 1(b). hours per response .........
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----- Form 3 Holdings
Reported
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----- Form 4 Transactions
X Reported
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
ANNUAL 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
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1. Name and Address of Reporting Person*
Hilal Peter K.
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(Last) (First) (Middle)
c/o Hilal Capital Management LLC
60 East 42nd Street
Suite 1946
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(Street)
New York NY 10165
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Applied Molecular Evolution, Inc. (AMEV)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
9/2000
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5. If Amendment, Date of Original (Month/Year)
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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>
<CAPTION>
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A)
(Instr. 3) action action or Disposed of (D)
Date Code (Instr. 3, 4 and 5)
------ (Instr. 8) --------------------------
(Month/ ----------- Amount (A) or Price
Day/ (D)
Year)
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<S> <C> <C> <C> <C> <C>
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Common Stock 7/27/00 P4 278,645 A 19.00
See note (1) under
Explanation of Responses,
below.
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Common Stock 7/31/00 J4 444,445 See See note
See note (3) under See note (4) note (4) (4) under
Explanation of Responses, under under Explanation
below. Explanation Expla- of Respons-
of Responses, nation es, below.
below. of Res-
ponses,
below.
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5. Amount of 6. Ownership 7. Nature of
Securities Form: Direct Indirect
Beneficially (D) or Indirect Beneficial
Owned at End (1) (Instr. 4) Ownership
of Issuer's (Instr. 4)
Fiscal Year
(Instr. 3
and 4)
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<C> <C> <C>
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0 D/I See note (2)
See note (2) under Expla-
under Explanation nation of
of Responses, Responses,
below. below.
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0 D/I See note (2)
See note (2) under
under Explana- Explanation
tion of Res- of Responses,
ponses, below. below.
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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)
(Print or Type Responses)
<PAGE>
FORM 5 (continued)
<TABLE>
<CAPTION>
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. Transac- 4. Transac- 5. Number of
Security (Instr. 3) sion or tion Date tion Code Derivative
Exercise (Month/ (Instr. 8) Securities
Price of Day/ ------------ Acquired (A)
Deriv- Year) or Disposed
ative of (D) (Instr.
Security 3, 4, and 5)
-------------
(A) (D)
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<S> <C> <C> <C> <C> <C>
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6. Date Exer- 7. Title and Amount 8. Price of 9. Number of
cisable and Ex- of Underlying Derivative Derivative
piration Date Securities Security Securities
(Month/Day/ (Instr. 3 and 4) (Instr. 5) Beneficially
Year) ------------------- Owned at
------------------ Amount or End of Year
Date Expira- Title Number of (Instr. 4)
Exer- tion Shares
cisable Date
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<C> <C> <C> <C> <C> <C>
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10. Ownership 11. Nature of
of Indirect
Derivative Beneficial
Security: Ownership
Direct (D) or (Instr. 4)
Indirect (I)
(Instr. 4)
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<C> <C>
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</TABLE>
Explanation of Responses:
(1) This information relates to shares of Common Stock of AMEV purchased on
the IPO date at the IPO price.
(2) The undersigned beneficially owns shares of Common Stock of AMEV held
directly by Hilal Capital, LP ("HCLP"), Hilal Capital QP, LP ("HCQP"),
another discretionary account ("the Account"), Hilal Capital International,
Ltd. ("HCI") and Hilal Capital Associates LLC ("HCA"). Hilal Capital
Partners LLC ("HCP") serves as general partner to, and has investment
discretion over securities held by, HCLP, HCQP and HCA. Hilal Capital
Management LLC ("HCM") serves as the investment manager to, and has investment
discretion over, the securities held by HCI and the Account. The undersigned
is the managing member of HCP and HCM. In accordance with Instruction
4(b)(iv), the entire number of shares of Common Stock of AMEV held by HCLP,
HCQP, the Account, HCI and HCA is reported herein. The undersigned disclaims
any beneficial ownership of the securities to which Form 5 relates for
purposes of Section 16 of the Securities and Exchange Act of 1934, as amended,
except as to such securities representing the undersigned's pro rata interest
in, and interest in the profits of, HCLP, HCQP, the Account, HCI and HCA.
(3) Shares of AMEV transferred from the Account to HCI in exchange for shares
of HCI. (See note 4).
(4) On July 31, 2000, the Account transferred shares of Common Stock of AMEV
to HCI in an exchange for shares of HCI. The Common Stock of AMEV had a
market value of $26 3/8 per share as of July 31, 2000, the effective date of
such transfer.
**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.
/s/Peter K. Hilal October 17, 2000
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**Signature of Reporting Person Date
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