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FORM 3 OMB APPROVAL
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OMB Number 3235-0104
Expires: February 1, 1994
Estimated average burden
hours per response . . . . 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
<TABLE>
<CAPTION>
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<S> <C> <C> <C>
1. Name and Address of Reporting Person 2. Date of Event Re- 4. Issuer Name and Ticker or Trading Symbol
quiring Statement Mehl/Biophile International Corporation - MEHL
Clearwater Fund IV, LLC (Month/Day/Year) ------------------------------------------------------------------
2/28/97 5. Relationship of Reporting 6. If Amendment,
- ------------------------------------------------------------------ Person to Issuer Date of Original
(Last) (First) (Middle) 3. IRS or Social Security (Check all applicable) (Month/Day/Year)
Number of Reporting
611 Druid Road East, Suite 200 Person ____ Director X 10% Owner
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(Street) ____ Officer (give ___ Other (specify N/A
title below) below)
Clearwater, Florida 34616 __________________________
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(City) (State) (Zip) Table I -- Non-Derivative Securities Beneficially Owned
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1. Title of Security 2. Amount of Securities Bene- 3. Ownership Form: Direct 4. Nature of Indirect Beneficial
(Instr. 4) ficially Owned (Instr. 4) (D) or Indirect (I) Ownership (Instr. 5)
(Instr. 5)
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Common Stock, $.01 par value per share 2,000,000 shares (I) (1)
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Common Stock, $.01 par value per share 113,600 shares (D) N/A
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly. (Over)
(Print or Type Responses) SEC 1473 (3/91)
(1) The shares are owned by Clearwater Fund IV Ltd. which is wholly owned by the
Reporting Person.
<PAGE>
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned (e.g., puts,
calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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<S> <C> <C> <C> <C> <C>
1. Title of Derivative Security 2. Date Exercisable 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of In-
(Instr. 4) and Expiration Date Underlying Derivative Security sion or ship direct Bene-
(Month/Day/Year) (Instr. 4) Exercise Form of ficial
--------------------------------------------------------- Price of Deriv- Ownership
Date Ex- Expiration Amount or Derivative ative (Instr. 5)
ercisable Date Title Number of Security Security:
Shares Direct
(D) or
Indirect
(I)
(Instr. 5)
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5% Cumulative Convertible (2) (2) (2) (2) (2) (2) (2)
Preferred Stock, Series E
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Warrant for the Purchase 8/5/97 8/5/02 Common Stock, 750,000 $2.50 (D) N/A
of Common Stock par value $.01
per share
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</TABLE>
Explanation of Responses:
(2) The Reporting Person directly owns 8,000 shares of 5% Cumulative
Convertible Preferred Stock, Series E ("Series E Preferred Stock") and
indirectly owns 2,231 shares of Series E Preferred Stock owned by
Clearwater Fund IV Ltd. by virtue of the Reporting Person's 100% ownership
of Clearwater Fund IV Ltd. The Series E Preferred Stock is convertible
into the Common Stock, par value $.01 per share, of the issuer ("Common
Stock") at any time at 80% of the average market price of the Common Stock
for the five trading days prior to conversion, subject to certain
limitations. If the 8,000 shares of Series E Preferred Stock directly
owned by the Reporting Person were converted as of August 23, 1997, said
Series E Preferred Stock would be converted into 3,703,704 shares of
Common Stock. If the 2,231 shares of Series E Preferred Stock indirectly
owned by the Reporting Person were converted as of August 23, 1997, said
Series E Preferred Stock would be converted into 1,032,870 shares of
Common Stock.
CLEARWATER FUND IV, LLC
By /s/ Hans Frederic Heye
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August 28, 1997 Name: Hans Frederic Heye
- ----------------- Title: Managing Member
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.
Page 2
SEC 1473 (3/91)
