FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/12/2004 |
3. Issuer Name and Ticker or Trading Symbol
QUESTCOR PHARMACEUTICALS INC [ QSC ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B Convertible Preferred Stock | (1) | 01/01/2006(2) | Common Stock | 2,124,947 | 0.9412 | D(3) | |
Warrants | (1) | 01/15/2007 | Common Stock | 679,982 | 0.9412 | D(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. Immediately. |
2. The shares are redeemable by the Issuer commencing January 1, 2006. In addition, upon the occurrence of certain events, each holder of the shares has the right to require the issuer to redeem its shares. |
3. The reported securities are owned directly by Montreux Equity Partners II SBIC, L.P., and may be deemed to be beneficially owned indirectly by (i) Montreux Equity Management II SBIC, LLC, as general partner of Montreux Equity Partners II SBIC, L.P., (ii) Howard D. Palefsky, as a managing member of Montreux Equity Management II SBIC, LLC, and (iii) Daniel K. Turner, III, as a managing member of Montreux Equity Management II SBIC, LLC. Montreux Equity Management II SBIC, LLC, Mr. Palefsky and Mr. Turner disclaim any beneficial ownership of the reported securities except to the extent of any pecuniary interest they may have therein. |
Remarks: |
The reporting persons may be deemed to be members of a Section 13(d) group that beneficially owns more than 10% of the Issuer's outstanding common stock. |
/s/ Howard D. Palefsky For Montreux Equity Management II SBIC, LLC, as general partner of Montreux Equity Partners II SBIC, L.P. | 02/12/2004 | |
/s/ Howard D. Palefsky | 02/12/2004 | |
/s/ Daniel K. Turner, III | 02/12/2004 | |
/s/ Daniel K. Turner, III For Montreux Equity Management II SBIC, LLC | 02/12/2004 | |
** Signature of Reporting Person | Date | |
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). | ||
** 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 is insufficient, see Instruction 6 for procedure. | ||
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 Number. |