--------------------------
OMB APPROVAL
--------------------------
OMB Number: 3235-0104
Expires: October 31, 2001
Estimated average burden
hours per response.....0.5
--------------------------
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
(Print or Type Responses)
_______________________________________________________________________________
1. Name and Address of Reporting Person*
Hays Russell D.
-------------------------------------------------------------------------------
(Last) (First) (Middle)
C/O BioSource International, Inc.
542 Flynn Road
-------------------------------------------------------------------------------
Camarillo, CA 93012
-------------------------------------------------------------------------------
(City) (State) (Zip)
_______________________________________________________________________________
2. Date of Event Requiring Statement (Month/Day/Year)
September 18, 2000
_______________________________________________________________________________
3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
_______________________________________________________________________________
4. Issuer Name and Ticker or Trading Symbol
BioSource International, Inc. (Nasdaq "BIOI")
_______________________________________________________________________________
5. Relationship of Reporting Person to Issuer (Check all applicable)
[X] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
President and Chief Executive Officer
_______________________________________________________________________________
6. If Amendment, Date of Original (Month/Day/Year)
9/28/00
_______________________________________________________________________________
7. Individual or Joint/Group Filing (Check Applicable Line)
[x] Form Filed by One Reporting Person
[ ] Form Filed by More than one Reporting Person
_______________________________________________________________________________
<TABLE>
<CAPTION>
TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
-----------------------------------------------------------------------------------------------
2. 3.
Amount of Ownership
Securities Form: 4.
1. Beneficially Direct (D) or Nature of Indirect
Title of Security Owned Indirect (I) Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5)
-----------------------------------------------------------------------------------------------
<S> <C> <C> <C>
Common Stock, par value
$0.001 per share 40,000 D
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------
</TABLE>
* If the form is filed by more than one reporting person, SEE Instruction
5(b)(v).
SEC 1472 (3-99)
<PAGE>
--------------------------------------------------------------------------------
TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS,
CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
--------------------------------------------------------------------------------
<TABLE>
<CAPTION>
2. 3.
Date Title and Amount
Exercisable and of Securities Underlying 5.
Expiration Date Derivative Security 4. Ownership Form
1. (month/day/year) (Instr. 4) Conversion of Derivative
Title of ---------------- -------------------------- or Exercise Securities 6.
Derivative Date Expira- Amount or Price of Direct (D) or Nature of Indirect
Security Exer- tion Number of Derivative Indirect (I) Beneficial Ownership
(Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
-----------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Options to
purchase Common Common
Stock * 9/18/10 Stock 350,000 $15.00 D
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Explanation of Responses:
* Exercisable as to 25% on each of September 18, 2001, September 18,
2002, September 18, 2003 and September 18, 2004.
/S/ RUSSELL D. HAYS October 27, 2000
-------------------------------------- ---------------------
**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
a currently valid OMB number
Page 2
SEC 1473 (3-99)
