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OMB APPROVAL
FORM 5 ----------------------------
OMB Number: 3235-0362
[ ] Check box if no longer subject to Expires: December 31, 2001
Section 16. Form 4 or Form 5 obligations Estimated average burden
may continue. See Instruction 1(b). hours per response.....1.0
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
UNITED STATES 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* 2. Issuer Name and Ticker or Trading Symbol
Kantor, Michael Pharmacia Corporation PHA
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(Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for
Number of Reporting Month/Year
Person, if an entity
100 Route 206 North (Voluntary) December 2001
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(Street) 5. If Amendment,
Date of Original
Peapack, NJ 07977 (Month/Year)
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(City) (State) (Zip)
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6. Relationship of Reporting Person(s) to Issuer
(Check all Applicable)
X Director 10% Owner
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Officer (give Other (specify
-------- title below) ------- below)
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7. Individual or Joint/Group Reporting
(check Applicable Line)
X Form filed by One Reporting Person
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Form filed by More than One Reporting Person
__
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A)
(Instr. 3) action action or Disposed of (D)
Date Code (Instr. 3, 4 and 5)
(Instr. 8)
(Month/ ----------------------------------------------------------
Day/ Amount (A) or Price
Year) (D)
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Common 04/17/2001 A 2,200 A $51.09
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5. Amount of 6. Ownership 7. Nature of
Securities Form: Direct (D) Indirect
Beneficially or Indirect (I) Beneficial
Owned at (Instr. 4) Ownership
end of Issuer's (Instr. 4)
Fiscal Year
(Instr. 3 and 4)
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5,200 D
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*If the form is filed by more than one reporting person, see
Instruction 4(b)(v).
(Over)
SEC 2270 (3-99)
Page 1 of 3
FORM 5 (continued)
Kantor, Michael -- December 2001
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned (e.g., puts, calls, warrants,
options, convertible securities)
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1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of 6. Date Exercisable
Security (Instr. 3) sion or action tion Code Derivative and Expiration Date
Exercise Date (Instr. 8) Securities (Month/Day/Year)
Price of Acquired (A)
Derivative (Month/ or Disposed of
Security Day/ (D)
Year) (Instr. 3, 4, and 5)
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(A) (D) Date Expi-
Exercis- ration
able Date
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Option (right to buy) $44.25 (1) 11/21/2007
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7. Title and Amount of 8. Price of 9. Number of 10. Ownership 11. Nature
Underlying Securities Derivative Derivative of Derivative of Indirect
(Instr. 3 and 4) Security Securities Security: Beneficial
(Instr. 5) Beneficially Direct (D) Ownership
Owned at or Indirect (Instr. 4)
End of (I)
Year (Instr. 4)
(Instr. 4)
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Title Amount or
Number of
Shares
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Common 21,818 21,818 D
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Explanation of Responses:
See attached statement
**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.
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.
Don W. Schmitz 2/14/2002
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** Signature of Reporting Person Date
Don W. Schmitz, attorney-in-fact for
Michael Kantor
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SEC 2270 (3-99)
Page 2 of 3
Pharmacia Corporation PHA
Form 5 - December 2001
Kantor, Michael
100 Route 206 North
Peapack, NJ 07977
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Explanation of responses:
(1) Option is currently exercisable.
Page 3 of 3