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FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB Approval
------------------------- WASHINGTON, D.C. 20549 ------------------------------
[X] Check box if no OMB Number: 3235-0362
longer subject to Expires: PENDING
Section 16. Form 4 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden
or Form 5 obligations hours per response.......1.0
may continue. See ------------------------------
Instruction 1(b). Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
[ ] Form 3 Holdings Section 17(a) of the Public Utility Holding Company Act of 1935 or
Reported Section 30(f) of the Investment Company Act of 1940
[X] Form 4 Transactions
Reported
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
Immtech International, Inc. ("IMMT")
Anderson Byron E [X] Director [ ] 10% Owner
------------------------------------------- ------------------------ -------------------- [ ] Officer (give [ ] Other (specify
(Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for title below)
Number of Reporting Month/Year below)
Person, if an entity
(Voluntary) For period ending
5801 Reba Street 12/17/01 ------------------------------------
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(Street) 5. If Amendment, 7. Individual or Joint/Group Reporting
Date of Original (Check Applicable Line)
(Month/Year) [X] Form Filed by One Reporting Person
[ ] Form Filed by More than One
Morton Grove IL 60053 01/11/02 Reporting Person
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(City) (State) (Zip)
TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect
Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial
(Month/ Owned at end or Indirect Ownership
Day/ of Issuer's (I) (Instr. 4)
Year) Fiscal Year (Instr. 4)
(Instr. 3
and 4)
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Amount (A) or (D) Price
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Common Stock 11/16/01 S4 500 D 5.7128 D
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Common Stock 11/20/01 S4 500 D 5.306 D
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Common Stock 11/21/01 S4 250 D 5.3515 D
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Common Stock 11/26/01 S4 500 D 5.2029 D
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Common Stock 12/3/01 S4 500 D 5.2025 D
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Common Stock 12/5/01 S4 500 D 5.0812 D
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Common Stock 12/7/01 S4 500 D 5.2005 73,611 D
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Common Stock 8,711 I Held
By Spouse
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TOTAL: 3,250 82,322
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* If the form is filed by more than one reporting person, see instruction 4(b)(v).
FORM 5 (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 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of
of sion or action action Derivative Exer- and of of ship of Indirect
Deriv- Exercise Date Code Securities cisable Amount Deriv- Deriv- Deriv- Beneficial
ative Price of (Month/ (Instr. Acquired (A) and Expir- of ative ative ative Ownership
Secu- Deriv- Day/ 8) or Disposed ation Under- Secu- Secu- Security: (Instr. 4)
rity ative Year) of (D) Date lying rity rities Direct
(Instr. Security (Instr. 3, (Month/ Securi- (Instr. Benefi- (D) or
3) 4, and 5) Day/ ties 5) cially Indirect
Year) (Instr. Owned (I)
3 and 4) at end (Instr.
of 4)
Year
(Instr.
4)
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(A) (D) Date Expir- Title Amount
Exercis- ation or
able Date Number
of
Shares
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Non 10.00 per July 20, A 5,000 Immediately 7/20/06 Common 5,000 10.00 5,000 D
Qualified share 2001 Stock
Stock
Option
(right
to buy)
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/s/ Byron E. Anderson 1/09/02
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** Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute
Federal Criminal Violations.
See 18 U.S.C. 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.