FORM 3
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
1. Name and Address of Reporting Person
Last, First, Middle
====================== ====================== ===================
Perry, Richard C.
Street
=============================================================
2635 Century Parkway, N.E.
Suite 1000
City, State, Zip
=============================================================
Atlanta, GA 30345
2. Date of Event Requiring Statement (Month/Day/Year)
June 4, 1996
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Issuer Name and Ticker or Trading Symbol
Bentley Pharmaceuticals, Inc. BNT
5. Relationship of Reporting Person to Issuer (Check all applicable)
Director:
Officer (give title below):
10% Owner: X
Other (specify below):
6. If Amendment, Date of Original (Month/Day/Year)
<TABLE>
<CAPTI0N>
TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
<C> <C> <C> <C>
1. Title of Security 2. Amount of Securities 3. Ownership Form 4. Nature of Indirect
Beneficially Owned Beneficial Ownership
</TABLE>
TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls,
warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)
Bentley Pharmaceuticals, Inc. Class A Redeemable Warrants
BNT/WSA
2. Date Exercisable and Expiration Date (Month/Day/Year)
Date Exercisable: Expiration Date:
----------------- ----------------
July 14, 1996 February 14, 1999
3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
Title: Amount or No. of Shares:
--------------------------- ------------------------
Common Stock 1 share
Class B Redeemable Warrants 1 warrant
4. Conversion or Exercise Price of Derivative Security
$3.00
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
D
6. Nature of Indirect Beneficial Ownership (Instr. 5)
Explanation of Responses:
Class B Redeemable Warrants are convertible by the holder for one
share of common stock for every two Class B Warrants held. This
conversion may be exercised at a price of $5.00 per share. Class
B Warrants expire February 14, 2001.
/s/ Richard C. Perry 7/15/96
----------------------------- ------------
Signature of Reporting Person Date
