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FORM 3 OMB APPROVAL
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U.S. SECURITIES AND EXCHANGE COMMISSION OMB Number: 3235-0104
WASHINGTON, DC 20549 Expires: January 31, 2005
Estimated average burden
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES hours per response....0.5
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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
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1. Name and Address of Reporting Person 2. Date of Event Requiring 4. Issuer Name and Ticker or Trading Symbol
Statement
Mendez David N. (Month/Day/Year) SiriCOMM, Inc. (f/k/a Fountain Pharmaceuticals, Inc. (SIRC)
------------------------------------------ 11/21/02 -----------------------------------------------------------
(Last) (First) (Middle) ---------------------------- 5. Relationship of Reporting 6.If Amendment, Date
3. IRS or Social Security Person to Issuer of Original
2900 Davis boulevard, Suite 130 Number of Reporting (Check all applicable) (Month/Day/Year)
------------------------------------------ Person (Voluntary) [X] Director [ ] 10% Owner
(Street) [X] Officer [ ] Other(specify 7.Individual or Joint/Group
-------------------------- (give title below) Filing (Check Applicable
Joplin, Missouri 64804 below) Line)
------------------------------------------ Exec. Vice President - [X] Form filed by One
(City) (State) (Zip) Sales & Marketing Reporting Person
[ ] Form filed by More
than One Reporting
Person
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TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
(Instr. 4) Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership (Instr. 5)
(Instr. 5)
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Common Stock, $.001 par value 1,098,331 D N/A
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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 5(b)(v).
Persons who respond to the collection of information contained in this form are not required to
respondunless the form displays a currently valid OMB control number.
(Over)
SEC 1473 (7-02)
FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership
Expiration Date Derivative Security Exercise Form of (Instr. 5)
(Month/Day/ (Instr. 4) Price of Deriv-
Year) Deri- ative
vative Security:
Security Direct
------------------------------------------------- (D) or
Date Expira- Amount or Indirect (I)
Exercis- tion Title Number (Instr. 5)
able Date of Shares
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None
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Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal /s/ David N. Mendez 11/21/02
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- -----------
**Signature of Reporting Person
Note. File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, See Instruction 6 for procedure. David N. Mendez
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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