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- ------
FORM 4
- ------ U.S. SECURITIES AND EXCHANGE COMMISSION
[ ] Check box if no longer WASHINGTON, DC 20549
subject to Section 16. Form
4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
continue. See Instruction 1(b).
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(1)|2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person
| | to Issuer (Check all applicable)
Molex Incorporated | Sheldahl, Inc. (SHEL) | Director X 10% Owner
- -------------------------------------------------------------------------------------------| ----- -----
(Last) (First) (Middle) |3. IRS Identification | 4. Statement for | Officer (give title below)
| Number of | Month/Year | -----
| Reporting Person, | | Other (specify below)
2222 Wellington Court | if an Entity | January, 2000 | -----
| (Voluntary) | |
- -----------------------------------------| |-------------------------|----------------------------------------
(Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing
| 36-2369491 | Date of Original | X (Check applicable line)
| | (Month/Year) | -- Form Filed by One Reporting Person
Lisle Illinois 60532 | | |
- -----------------------------------------|-------------------------------------------------| -- Form Filed by More than One
(City) (State) (Zip) | | 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. Transaction| 3. Transaction|4. Securities Acquired (A)| 5. Amount of|6. Owner- |7. Nature
(Instr. 3) | Date | Code | or Disposed of (D) | Securities | ship | of
| | (Instr. 8) | (Instr. 3, 4 and 5) | Beneficially| Form: | Indirect
| | | | Owned at End| Direct | Bene-
| |---------------|--------------------------| of Month | (D) or | ficial
| | | | | (A) | | (Instr. 3 | Indirect | Owner-
| (Month/Day/ | | | | or | | and 4) | (I) | ship
| Year) | Code | V | Amount | (D) | Price | |(Instr. 4)|(Instr. 4)
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
Common Stock | | | | | | |2,787,176(1) | D |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
- --------------------------------------|--------------|-------|-------|--------|------|----------|-------------|--------- |---------
| | | | | | | | |
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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 (OVER)
INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO SEC 1473(3-99)
RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB
CONTROL NUMBER.
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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)
| | | | |-------------------------------------|
| | | | |Date |Expira- | | Amount or |
| | |-------------------------------|Exer- |tion | Title | Number of |
| | | Code |V | (A) |(D) |cisable|Date | | Shares |
- ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
Series F Convertible | $5.46(2) | 1/11/00 | P | | 1,300 | |1/11/00| (3) | Common | (4) | $1,000
Preferred Stock | | | | | | | | | Stock | |
- ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
Series F Warrant | $5.46(2) | 1/11/00 | P | | 40,300 | |1/11/00|1/11/05 | Common | 40,300 | (5)
| | | | | | | | | Stock | |
- ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
Series D Convertible | $6.15(2) | | | | | |7/30/98| (6) | Common | (4) | $1,000
Preferred Stock | | | | | | | | | Stock | |
- ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------
Series D Warrant | $7.6875(2) | | | | | |7/30/98|7/29/01 | Common | 120,000 | (5)
| | | | | | | | | 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) |
- ------------------|------------------------|------------------------------
1,300 | D |
- ------------------|------------------------|------------------------------
40,300 | D |
- ------------------|------------------------|------------------------------
12,000 | D |
- ------------------|------------------------|------------------------------
120,000 | D |
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| |
- ------------------|------------------------|------------------------------
| |
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Explanation of Responses:
/s/ LOUIS HECHT February 10, 2000
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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 provided 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 currently
valid OMB Number.
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FORM 4 (continued)
1. Molex Incorporated
2222 Wellington Court
Lisle, Illinois 60532
2. Sheldahl, Inc. (SHEL)
4. Statement for January, 2000
Explanation of Responses:
(1) This amount assumes the exercise of the Warrants and conversion of the
Convertible Preferred Stock held by Molex Incorporated into Common Stock
(without regard to accrued but unpaid dividends).
(2) The Conversion Price is subject to adjustment from time to time as provided
in the Certificate of Designation, Preferences and Rights ("Certificate of
Designation") for Series F Convertible Preferred Stock and Series D
Convertible Preferred Stock.
(3) Each share of Series F Convertible Preferred Stock is convertible by the
holder into shares of Common Stock at the Conversion Ratio (defined in Note
4 below) at the option of the holder in whole or in part at any time after
January 11, 2000 ("Exercise Date"). If, at any time after six months
following Exercise Date, the per share market value of the Common Stock is
greater than $10.92 for at least 30 consecutive business days and the
average daily trading volume of the Common Stock on the Nasdaq National
Market for such 30 consecutive business days exceeds 50,000 shares (subject
to adjustment), then Sheldahl, Inc. may, upon 10 days notice, require the
conversion of all of the then outstanding Series F Convertible Preferred
Stock at the Conversion Ratio on the conversion date. Furthermore, all of
the then outstanding Series F Convertible Preferred Stock shall
automatically be converted at the Conversion Ratio on the date of the
closing of a Series F Public Offering (as defined in the Certificate of
Designation) or such other date as directed by the managing underwriter.
(4) Conversion Ratio for Series F Convertible Preferred Stock and Series D
Convertible Preferred Stock equals a fraction of which the numerator is the
Stated Value ($1,000) plus accrued but unpaid dividends (including any
accrued but unpaid interest thereon) and of which the denominator is the
Conversion Price at such time. The number of shares listed does not reflect
any accrued but unpaid dividends.
(5) A partial consideration for the purchase of Series F Convertible Preferred
Stock was the issuance of Series F Warrant by Sheldahl, Inc. to Molex
Incorporated. A partial consideration for the purchase of Series D
Convertible Preferred Stock was the issuance of Series D Warrant by
Sheldahl, Inc. to Molex Incorporated.
(6) Each share of Series D Convertible Preferred Stock is convertible by the
holder into shares of Common Stock at the Conversion Ratio (defined in Note
4 above) at the option of the holder in whole or in part at any time after
July 30, 1998 ("Exercise Date"). If, at any time after six months following
Exercise Date, the per share market value of the Common Stock is greater
than $12.30 for at least 30 consecutive business days and the average daily
trading volume of the Common Stock on the Nasdaq National Market for such
30 consecutive business days exceeds 50,000 shares (subject to adjustment),
then Sheldahl, Inc. may, upon 10 days notice, require the conversion of all
of the then outstanding Series D Convertible Preferred Stock at the
Conversion Ratio on the conversion date. Furthermore, all of the then
outstanding Series D Convertible Preferred Stock shall automatically be
converted at the Conversion Ratio on the date of the closing of a Series D
Public Offering (as defined in the Certificate of Designation) or such
other date as directed by the managing underwriter.
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