FORM 4
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
/ X / Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue.
See Instruction 1(b).
1. Name and Address of Reporting Person*:
Thomas J. Tisch ("TJT")
------------------------------
(LAST) (FIRST) (MIDDLE)
667 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
<PAGE>
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
_____ Officer (give title below)
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
-2-
<PAGE>
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
I
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation of Responses)
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).
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
-3-
<PAGE>
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
-4-
<PAGE>
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
This Form 4 is being filed jointly by the following individuals and
entities:
1. Thomas J. Tisch;
2. Daniel R. Tisch;
3. James S. Tisch;
4. Andrew H. Tisch (Thomas J. Tisch, Daniel R. Tisch, James S. Tisch
and Andrew H. Tisch are referred to collectively as the "Messrs. Tisch");
5. The Thomas J. Tisch 1999 Annuity Trust III ("Thomas Tisch GRAT
III");
6. The Daniel R. Tisch 1999 Annuity Trust III ("Daniel Tisch GRAT
III");
-5-
<PAGE>
7. The James S. Tisch 1999 Annuity Trust III ("James Tisch GRAT III");
and
8. The Andrew H. Tisch 1999 Annuity Trust III ("Andrew Tisch GRAT III";
and collectively with Thomas Tisch GRAT III, Daniel Tisch GRAT III and James
Tisch GRAT III, the "GRATs").
Thomas J. Tisch, Daniel R. Tisch, James S. Tisch, Andrew H. Tisch,
Thomas Tisch GRAT III, Daniel Tisch GRAT III, James Tisch GRAT III, and Andrew
Tisch GRAT III are referred to herein individually as a "Reporting Person" and
collectively as the "Reporting Persons."
TJT is the designated filer.
Each of the GRATs is a grantor retained annuity trust in which the
grantor holds an annuity interest and in which the remainder interest was
created in favor of a trust or trusts for the grantor's offspring. Thomas J.
Tisch is the grantor and Andrew H. Tisch is the trustee of Thomas Tisch GRAT
III. Daniel R. Tisch is the grantor and James S. Tisch is the trustee of Daniel
Tisch GRAT III. James S. Tisch is the grantor and Thomas J. Tisch is the trustee
of James Tisch GRAT III. Andrew H. Tisch is the grantor and Daniel R. Tisch is
the trustee of Andrew Tisch GRAT III.
Each of the Messrs. Tisch is herein reporting beneficial ownership of
the shares of Common Stock owned by the GRAT for which he is the grantor.
The filing of this statement is not an admission by any Reporting
Person that such Reporting Person and any other person or persons constitute a
"group" for purposes of Section 13(d)(3) of the Securities Exchange Act of 1934,
as amended, or Rule 13d-5 thereunder or that any Reporting Person is the
beneficial owner of any securities owned by any other person.
[Signatures follow all attachments]
-6-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
Daniel R. Tisch
------------------------------------------
(LAST) (FIRST) (MIDDLE)
c/o Mentor Partners, L.P.
499 Park Avenue
-------------------------------------------
(STREET)
New York, New York 10022
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
_____ Officer (give title below)
-7-
<PAGE>
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-8-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
I
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-9-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
-10-
<PAGE>
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-11-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
James S. Tisch
------------------------------------------
(LAST) (FIRST) (MIDDLE)
667 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
_____ Officer (give title below)
-12-
<PAGE>
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-13-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
I
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-14-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
-15-
<PAGE>
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-16-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
Andrew H. Tisch
------------------------------------------
(LAST) (FIRST) (MIDDLE)
667 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
_____ Officer (give title below)
-17-
<PAGE>
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-18-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
I
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-19-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
-20-
<PAGE>
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-21-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
Thomas J. Tisch 1999 Annuity Trust III
------------------------------------------
(LAST) (FIRST) (MIDDLE)
c/o Barry Bloom
665 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
-22-
<PAGE>
_____ Officer (give title below)
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-23-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
D
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-24-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
-25-
<PAGE>
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-26-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
Daniel R. Tisch 1999 Annuity Trust III
------------------------------------------
(LAST) (FIRST) (MIDDLE)
c/o Barry Bloom
665 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
-27-
<PAGE>
_____ Officer (give title below)
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-28-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
D
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-29-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
-30-
<PAGE>
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-31-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
James S. Tisch 1999 Annuity Trust III
------------------------------------------
(LAST) (FIRST) (MIDDLE)
c/o Barry Bloom
665 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
-32-
<PAGE>
_____ Officer (give title below)
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-33-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
D
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
-34-
<PAGE>
4. Transaction Code:
(Instr. 8)
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
-35-
<PAGE>
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-36-
<PAGE>
Attachment To Form 4 of Four Partners
in Respect of AutoImmune Inc. (AIMM)
Statement for: 11/99
Joint Filer Information
1. Name and Address of Reporting Person*:
Andrew H. Tisch 1999 Annuity Trust III
------------------------------------------
(LAST) (FIRST) (MIDDLE)
c/o Thomas J. Tisch
665 Madison Avenue
-------------------------------------------
(STREET)
New York, New York 10021
------------------------------------------
(CITY) (STATE) (ZIP)
2. Issuer Name and Ticker or Trading Symbol:
AutoImmune Inc. (AIMM)
3. IRS Identification Number of Reporting Person, if an entity (Voluntary):
4. Statement for Month/Year:
11/99
5. If Amendment, Date of Original:
(Month/Year)
6. Relationship of Reporting Person(s) to Issuer: (Check all applicable)
_____ Director
_____ Officer (give title below)
-37-
<PAGE>
__X__ 10% Owner
_____ Other (specify below)
7. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
_X___ Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired,
Disposed of, or Beneficially Owned
1. Title of Security:
(Instr. 3)
Common Stock, $0.01 par value
2. Transaction Date:
(Month/Day/Year)
11/26/99
3. Transaction Code:
(Instr. 8)
Code V
S
4. Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
Amount (A) or (D) Price
59,250 D $1.77
38,250 D $2.08
-38-
<PAGE>
5. Amount of Securities Beneficially Owned at End of Month:
(Instr. 3 and 4)
408,000
6. Ownership Form: Direct (D) or Indirect (I):
(Instr. 4)
D
7. Nature of Indirect Beneficial Ownership:
(Instr. 4)
(See Explanation to Form 4 of TJT.)
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
1. Title of Derivative Security:
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security:
3. Transaction Date:
(Month/Day/Year)
4. Transaction Code:
(Instr. 8)
-39-
<PAGE>
Code V
5. Number of Derivative Securities Acquired (A) or Disposed of (D):
(Instr. 3, 4 and 5)
(A) (D)
6. Date Exercisable and Expiration Date:
(Month/Day/Year)
Date Exercisable Expiration Date
7. Title and Amount of Underlying Securities:
(Instr. 3 and 4)
Title Amount or Number of Shares
8. Price of Derivative Security:
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned at End of Month:
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I):
(Instr. 4)
11. Nature of Indirect Beneficial Ownership:
-40-
<PAGE>
(Instr. 4)
Explanation of Responses:
[Signatures follow all attachments]
-41-
<PAGE>
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
/s/ Thomas J. Tisch
-----------------------------------
Thomas J. Tisch
/s/ Daniel R. Tisch
-----------------------------------
Daniel R. Tisch
/s/ James S. Tisch
-----------------------------------
James S. Tisch
/s/ Andrew H. Tisch
-----------------------------------
Andrew H. Tisch
THE THOMAS J. TISCH 1999 ANNUITY TRUST III
By /s/ Andrew H. Tisch
--------------------------------
Andrew H. Tisch, Trustee
THE DANIEL R. TISCH 1999 ANNUITY TRUST III
By /s/ James S. Tisch
--------------------------------
James S. Tisch, Truste
THE JAMES S. TISCH 1999 ANNUITY TRUST III
By /s/ Thomas J. Tisch
--------------------------------
Thomas J. Tisch, Trustee
THE ANDREW H. TISCH 1999 ANNUITY TRUST III
By /s/ Daniel R. Tisch
--------------------------------
Daniel R. Tisch, Trustee
Date: December 10, 1999
** 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 the Form, one of which must be manually signed. If
space provided is insufficient, see Instruction 6 for procedure.
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<PAGE>
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.
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