UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
VLAK GERARD J M 181 TURN OF THE RIVER ROAD NUMBER 7 STAMFORD, CT 06905 |
X |
Gerald J.M. Vlak | 04/26/2004 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Remarks: On April 25, 2004, Gerald J M Vlak became a director of OXIS International. The holdings reported in Table 1 include 13,982,567 shares held by Axonyx. Gosse B. Bruinsma, M.D., Gerald J. Vlak, Ph.D. and Steven H. Ferris, Ph. D. are each directors of Axonyx and each of Dr. Bruinsma and S. Colin Neill are executive officers of Axonyx. Each of the foregoing directors and officers disclaims beneficial ownership of the shares owned by Axonyx, except for his proportional interest therein, if any. |