U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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*
Wicker Damion E.
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(Last) (First) (Middle)
c/o Chase Capital Partners
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. Date of Event Requiring Statement (Month/Day/Year)
October 25, 2000
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
MediChem Life Sciences, Inc. ("MCLS")
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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6. If Amendment, Date of Original (Month/Day/Year)
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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 Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4)
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<S> <C> <C> <C>
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* If the Form is filed by more than one Reporting Person, see Instruction
5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
(Form 3-07/99)
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Class A Convertible
Preferred Stock
of MCR Holdings(FN 1) Immed N/A Common Stock 3,641,253 18.65557 for 1 I (FN 2)
(FN 1)
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</TABLE>
Explanation of Responses:
(1) Pursuant to the Articles of Incorporation of MCR Holdings, Inc. ("MCR"),
the parent of MediChem Life Sciences, Inc. (the "Issuer"), immediately prior to
the initial public offering of the Issuer the Class A Convertible Preferred
Stock of MCR will convert into shares of Class B Redeemable Stock of MCR, which
will be redeemed for cash, and on a 1-for-1 basis into shares of the Class A
Common Stock of MCR. Immediately prior to the close of the initial public
offering of the Issuer, MCR will merge into the Issuer and all outstanding
shares of the Class A Common Stock of MCR will automatically convert into
Common Stock of the Issuer on an 18.65557-for-1 basis. The amounts shown
represent the beneficial ownership of equity securities of the Issuer by
ChaseMediChem Partners, LLC ("MediChem") after the conversion and the merger.
A portion of the securities owned by MediChem may be deemed attributable to the
reporting person because he is a general partner of Chase Capital Partners
("CCP"), the managing member of Chase Equity Associates, LP ("CEA"). CEA is the
non-managing member of MediChem. The actual pro rata portion of the reporting
person's beneficial ownership is not readily determinable because it is subject
to several variables, including CEA's and CCP's internal rate of return and
vesting. Mr. Wicker disclaims ownership of the securities shown in the
Table to the extent it exceeds his indirect pecuniary interest in the Issuer.
/s/ Damion E. Wicker 10/25/2000
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Damion E. Wicker 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.
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