Form 5

FORM 5

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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(h) of the Investment Company Act of 1940

  


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Check this box if no longer subject
to Section 16. Form 4 or Form 5
  obligations may continue. See
   Instruction 1(b).

Form 3 Holdings Reported

Form 4 Transactions Reported

       

  

1. Name and Address of Reporting Person*          




Dance                 Stephen          G.

2. Issuer Name and Ticker or Trading Symbol





 SangStat Medical Corporation (SANG)

6. Relationship of Reporting Person(s) to Issuer
                  (Check all applicable)

 

Director

 

10% Owner

 X

Officer (give
title below)

 

Other (specify
below)

 Chief Financial Officer

(Last)                    (First)                (Middle)

c/o SangStat Medical Corporation
6300 Dumbarton Circle

3. I.R.S. Identification
   Number of Reporting
   Person, if an entity
   (Voluntary)

 

4. Statement for Month/Year

 2002


7. Individual or Joint/Group Reporting
              (check applicable line)

5. If Amendment, Date of
    Original (Month/Year)

 February 6, 2003

 X  

Form Filed by One Reporting Person

(Street)

Fremont,         CA       94555

   

Form Filed by More than One Reporting Person

(City)                      (State)                  (Zip)

Table I  ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
    (Instr. 3)

2. Trans-
    action
    Date
   (Month/
    Day/
   Year)

2A. Deemed
      Execu-
      tion
      Date, if
      any
     (Month/
      Day/
      Year)

3. Trans-
    action
    Code
    (Instr.8)

4. Securities Acquired (A) or
    Disposed of (D)
    (Instr. 3, 4 and 5)

5. Amount of
    Securities Ben-
    eficially Owned
    at end of
    Issuer's Fiscal
    Year
    (Instr. 3 and 4)

6. Owner-
    ship
    Form: Di-
    rect (D)
    or Indi-
    rect (I)
    (Instr. 4)

7. Nature of
    Indirect
    Beneficial
    Ownership
    (Instr. 4)

Amount

  (A) or
  (D)

Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*

If the form is filed by more than one reporting person, see instruction 4(b)(v).             

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.

     

                                 (Over)
                  SEC2270 (9-02)


FORM 5 (continued)

Table II  ¾ Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative
    Security (Instr. 3)

2. Conver-
    sion or
    Exercise
    Price of
    Deriva-
    tive Sec-
    urity

3. Trans
    -action
    Date
   (Month/
    Day/
    Year)

3A. Deem
      -ed Ex-
      ecution
      Date, if
      any
     (Month/
       Day/
       Year)

4. Trans-
    action
    Code
    (Instr.8)

5. Number of Deriva-
    tive Securities Ac-
    quired (A) or Dis-
    posed of (D)
    (Instr. 3, 4 and 5)

6. Date Exercis-
    able and Expi-
    ration Date
    (Month/Day/
     Year)

7. Title and Amount of Underly-
    ing Securities
    (Instr. 3 and 4)

8. Price
    of
    De-
    riva-
    tive
    Secu-
    rity
 (Instr. 5)

9. Number
   of De-
   rivative
   Securi-
   ties Ben-
   eficially
   Owned
   at End of
   Year
   (Instr. 4)

10. Owner-
      ship of
      Deriva-
      tive Se-
      curity:
      Direct
      (D) or
      Indirect
      (I)
      (Instr. 4)

11. Nature of
     Indirect
     Benefi-
     cial
     Owner-
     ship
     (Instr. 4)

(A)

(D)

  Date
  Exer-
  cisable

  Expira-
  tion
  Date

Title

 Amount or
 Number of
 Shares

Option to purchase Common Stock

$19.38

2/20/02

 

A

30,000

 

(1)

 2/20/12

Common Stock

30,000

 

30,000

D

 

Option to purchase Common Stock

$15.00

12/4/02

 

A

10,000

 

(1)

 12/4/12

Common Stock

10,000

 

10,000

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

(1)  Twenty-five percent (25%) shall vest after one year.  The remaining options shall vest in equal monthly installments over 36 months, contingent upon continuous service to the Company.

 

 

 /s/ Tamiko F. Lewis

          

 4/2/03

**

Intentional misstatements or omissions of facts constitute Federal Criminal Violations.

**Tamiko F. Lewis
Attorney-in-Fact for Stephen G. Dance

          

Date

See18 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 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.

 

     

 

 

 

     

 

 

 

     

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