OMB APPROVAL | ||
OMB Number: |
3235-0145 | |
Expires: |
December 31, 2005 | |
Estimated average burden hours per response |
11 | |
¨ |
Rule 13d-1(b) |
x |
Rule 13d-1(c) |
¨ |
Rule 13d-1(d) |
CUSIP NO. 435902 10 1 |
Page 2 of 7 |
1. |
NAMES OF REPORTING PERSONS. I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES
ONLY). R.E. & M. Petersen Living Trust Dated 1/17/83 | |
2. |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) ¨ (b) x Joint Report | |
3. |
SEC USE ONLY | |
4. |
CITIZENSHIP OR PLACE OF ORGANIZATION United States | |
5. |
SOLE VOTING POWER 0 | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
6. |
SHARED VOTING POWER 1,386,508 | ||
EACH REPORTING PERSON WITH |
7. |
SOLE DISPOSITIVE POWER 0 | ||
8. |
SHARED DISPOSITIVE POWER 1,386,508 | |||
9. |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,386,508 | |
10. |
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES
¨ | |
11. |
Percent of Class Represented by Amount in Row (9) 10.8% | |
12. |
Type of Reporting Person (See Instructions) OO | |
CUSIP NO. 435902 10 1 |
Page 3 of 7 |
1. |
NAMES OF REPORTING PERSONS. I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES
ONLY). Robert E. Petersen | |
2. |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) ¨ (b) x Joint Report | |
3. |
SEC USE ONLY | |
4. |
CITIZENSHIP OR PLACE OF ORGANIZATION United States | |
5. |
SOLE VOTING POWER 16,500 | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
6. |
SHARED VOTING POWER 1,386,508 | ||
EACH REPORTING PERSON WITH |
7. |
SOLE DISPOSITIVE POWER 16,500 | ||
8. |
SHARED DISPOSITIVE POWER 1,386,508 | |||
9. |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,403,008 | |
10. |
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES
¨ | |
11. |
Percent of Class Represented by Amount in Row (9) 10.8% | |
12. |
Type of Reporting Person (See Instructions) IN | |
CUSIP NO. 435902 10 1 |
Page 4 of 7 |
1. |
NAMES OF REPORTING PERSONS. I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES
ONLY). Margaret M. Petersen | |
2. |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) ¨ (b) x Joint Report | |
3. |
SEC USE ONLY | |
4. |
CITIZENSHIP OR PLACE OF ORGANIZATION United States | |
5. |
SOLE VOTING POWER 0 | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
6. |
SHARED VOTING POWER 1,386,508 | ||
EACH REPORTING PERSON WITH |
7. |
SOLE DISPOSITIVE POWER 0 | ||
8. |
SHARED DISPOSITIVE POWER 1,386,508 | |||
9. |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,386,508 | |
10. |
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES
¨ | |
11. |
Percent of Class Represented by Amount in Row (9) 10.8% | |
12. |
Type of Reporting Person (See Instructions) IN | |
Page 5 of 7 |
(a) |
Name of Issuer: Hollis-Eden Pharmaceuticals, Inc. |
(b) |
Address of Issuers Principal Executive Offices: 4435 Eastgate Mall, Suite 400, San Diego, CA 92121 |
(a) Name of Person Filing: |
R. E. & M. Petersen Living Trust dated 1/17/83 | |
Robert E. Petersen | ||
Margaret M. Petersen |
(b) |
Address of Principal Business Office or, if none, Residence: |
(c) |
Citizenship: United States |
(d) |
Title of Class of Securities: Common Stock, par value $.01 |
(e) |
CUSIP Number: 435902 10 1 |
(a) |
¨ Broker or Dealer
registered under Section 15 of the Act (15 U.S.C. 78o); |
(b) |
¨ Bank as defined in section
3(a)(6) of the Act (15 U.S.C. 78c); |
(c) |
¨ Insurance company as
defined in section 3(a)19) of the Act (15 U.S.C. 78c); |
(d) |
¨ An investment company
registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8); |
(e) |
¨ An investment adviser in
accordance with §240.13d-1(b)(1)(ii)(E); |
(f) |
¨ An employee benefit plan
or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F); |
(g) |
¨ A parent holding company
or control person in accordance with §240.13d-1(b)(ii)(G); |
(h) |
¨ A savings association as
defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); |
(i) |
¨ A church plan that is
excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); |
(j) |
¨ Group, in accordance with
§240.13d-1(b)(1)(ii)(J) |
(a) |
Amount Beneficially Owned as of December 31, 2002: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
1,386,508 shares | |
Robert E. Petersen |
1,403,008 shares | |
Margaret M. Petersen |
1,386,508 shares |
(b) |
Percent of Class: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
10.8% | |
Robert E. Petersen |
10.8% | |
Margaret M. Petersen |
10.8% |
(c) |
Number of shares as to which such person has: |
(i) |
Sole power to vote or to direct the vote: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
0 shares | |
Robert E. Petersen |
16,500 shares | |
Margaret M. Petersen |
0 shares |
Page 6 of 7 |
(ii) |
Shared power to vote or to direct the vote: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
1,386,508 shares | |
Robert E. Petersen |
1,386,508 shares | |
Margaret M. Petersen |
1,386,508 shares |
(iii) |
Sole power to dispose or to direct the disposition of: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
0 shares | |
Robert E. Petersen |
16,500 shares | |
Margaret M. Petersen |
0 shares |
(iv) |
Shared power to dispose or to direct the disposition of: |
R. E. & M. Petersen Living Trust dated 1/17/83 |
1,386,508 shares | |
Robert E. Petersen |
1,386,508 shares | |
Margaret M. Petersen |
1,386,508 shares |
Item 5. |
Ownership of Five Percent or Less of a Class: If this statement is being filed to report the fact as of the date hereof the
reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: ¨ |
Item 6. |
Ownership of More than Five Percent on Behalf of Another Person: Not Applicable |
Item 7. |
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control
Person: Not Applicable |
Item 8. |
Identification and Classification of Members of the Group: Not Applicable |
Item 9. |
Notice of Dissolution of a Group: Not Applicable |
Page 7 of 7 |
Dated as of January 13, 2003 |
R.E. & M. PETERSEN LIVING TRUST DATED 1/17/83 | |||||
By: |
/s/ Robert E. Petersen | |||||
Robert E. Petersen, Trustee | ||||||
By: |
/s/ Margaret M. Petersen | |||||
Margaret M. Petersen, Trustee |
/s/ Robert E. Petersen |
ROBERT E. PETERSEN |
/s/ Margaret M. Petersen |
MARGARET M. PETERSEN |
R.E. & M. PETERSEN LIVING TRUST DATED
1/17/83 | ||||||
By: |
/s/ Robert E. Petersen | |||||
Robert E. Petersen, Trustee | ||||||
By: |
/s/ Margaret M. Petersen | |||||
Margaret M. Petersen, Trustee |
/s/ Robert E. Petersen | ||
ROBERT E. PETERSEN |
/s/ Margaret M. Petersen | ||
MARGARET M. PETERSEN |