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FORM 5
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[ ] Check this box if no longer subject of Section 16.
Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[X] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL 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
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1. Name and Address of Reporting Person
Paramount Capital Asset Management, Inc.
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(Last) (First) (Middle)
787 Seventh Avenue, 48th Floor
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(Street)
New York, New York 10019
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Discovery Laboratories, Inc.
DSCO
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
December 1997
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [X] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5. 6.
4. Amount of Owner-
Security Acquired (A) or Securities ship
Disposed of (D) Beneficially Form: 7.
(Instr. 3, 4 and 5) Owned at End Direct Nature of
2. 3. ----------------------------- of Issuer's (D) or Indirect
1. Transaction Transaction Amount (A) Price Fiscal Year Indirect Beneficial
Title of Security Date Code or (Instr. 3 (I) Ownership
(Instr. 3) (Month/Day/Year) (Instr. 8) (D) & 4) (Instr.4) (Instr. 4)
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Common Stock 11/25/97 J(1)(2) 481,581 A (1) 481,581 I (3)
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or type Responses)
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. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
Title of Conver- Trans- Trans- Number of Date Title and Amount Price Number Owner- Nature
Derivative sion action action Derivative Exercisable and of Underlying of of ship of
Security or Date Code Securities Expiration Date Securities Deriv- Deriv- of In-
(Instr. 3) Exer- (Month/ (Instr. Acquired (A) (Month/Day/Year) (Instr. 3 and 4) ative ative Deriv- direct
cise Day/ 8) or Disposed ---------------- ---------------- Secur- Secur- ative Bene-
Price Year) of (D) Date Expira- Title Amount ity ities Secur- ficial
of (Instr. 3, Exer- tion or (Instr. Bene- ity: Owner-
Deriv- 4 and 5) cisable Date Number 5) ficially Direct ship
ative ------------ of Owned (D) or (Instr.
Secur- (A) (D) Shares at End In- 4)
ity of direct
Year (I)
(Instr. (Instr.
4) 4)
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Series B Convertible Common
Preferred Stock $6.42 11/25/97 J(1)(4) 247,500 11/25/97 N/A Stock 385,265 (1) 247,500 I (3)
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Common Stock Common
Warrants $0.64 11/15/96 J(5) 8,756 5/15/97 11/15/06 Stock 8,756 (1) 8,756 I (3)
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Series B
Series B Convert-
Convertible ible
Preferred Stock Preferred
Warrants $11.00 11/15/96 J(5) 22,500 5/15/97 11/15/06 Stock 22,500 (1) 22,500 I (3)
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Explanation of Responses:
(1) Securities acquired by Aries Domestic Fund, L.P., a Delaware limited
partnership ("Aries Domestic") and The Aries Fund, a Cayman Island Trust ("Aries
Fund") pursuant to the statutory merger (the "Merger") of Discovery
Laboratories, Inc., a former Delaware corporation ("Old Discovery") with and
into the Issuer (f/k/a Ansan Pharmaceuticals, Inc.). Pursuant to the Merger,
securities of Old Discovery held by Aries Domestic and Aries Fund were converted
into securities of the Issuer. The Reporting Person is the general partner of
Aries Domestic and also serves as the investment manager to Aries Fund and in
such capacities has the authority to make certain decisions on behalf of such
entities including decisions relating the securities of the Issuer. The
securities of Old Discovery surrendered by Aries Domestic and Aries Fund in the
Merger constituted the consideration for the securities of the Issuer issued to
Aries Domestic and Aries Fund in the Merger. The securities of Old Discovery
were not listed on a securities exchange or quoted on an inter-dealer quotation
system and, accordingly, the Issuer is unable to determine the value of such
consideration as of the date of the Merger. The Reporting Person disclaims
beneficial ownership of the securities held by Aries Domestic and Aries Trust,
except to the extent of its pecuniary interest therein, if any.
(2) Includes 385,265 shares of Common Stock issuable upon conversion of Series B
Convertible Preferred Stock (including Series B Convertible Preferred Stock
issuable upon exercise of Series B Convertible Preferred Stock Warrants) and
8,756 shares of Common Stock issuable upon exercise of Common Stock Warrants.
(3) The Reporting Person is the general partner in Aries Domestic and the
investment manager to Aries Fund. Aries Domestic and Aries Fund beneficially
own, directly, all of the securities reported on this Form 5 as being
beneficially owned by the Reporting Person.
(4) Includes 6,750 shares of Series B Convertible Preferred Stock issuable upon
exercise of Series B Convertible Preferred Stock Warrants held by Aries Domestic
and 15,750 shares of Series B Convertible Preferred Stock issuable upon exercise
of Series B Convertible Preferred Stock Warrants held by Aries Fund.
(5) The Common Stock Warrants and Series B Convertible Preferred Stock Warrants
were issued to Aries Domestic and Aries Fund in connection with a private
placement of equity securities of Old Discovery in which an affiliate of Aries
Domestic and Aries Fund (and of the Reporting Person) acted as placement agent.
The Common Stock Warrants and Series B Convertible Preferred Stock Warrants were
assumed by the Issuer in the Merger.
/s/ Lindsay A. Rosenwald February 13, 1998
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**Signature of Reporting Person Date
** 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 this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
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