Schedule 13G Page 1 of 5
================================================================================
SEC 1745 POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION
(6-00) OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED
TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID
OMB CONTROL NUMBER.
================================================================================
------------------------------
OMB APPROVAL
------------------------------
OMB Number: 3235-0145
------------------------------
Expires: October 31, 2002
------------------------------
Estimated average burden
hours per response.......14.9
------------------------------
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. )*
Ciphergen Biosystems, Inc.
-------------------------------------------------------------------------------
(Name of Issuer)
-------------------------------------------------------------------------------
Common Stock
-------------------------------------------------------------------------------
(Title of Class of Securities)
-------------------------------------------------------------------------------
17252Y 10 4
-------------------------------------------------------------------------------
(CUSIP Number)
-------------------------------------------------------------------------------
December 31, 2000
-------------------------------------------------------------------------------
(Date of Event which Requires Filing of this Statement)
-------------------------------------------------------------------------------
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
/ / Rule 13d-1(b)
/ / Rule 13d-1(c)
/X/ Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
Schedule 13G Page 2 of 5
CUSIP No. 17252Y 10 4
-------------------------------------------------------------------------------
1. Names of Reporting Persons. I.R.S. Identification Nos. of above
persons (entities only).
T. William Hutchens
-------------------------------------------------------------------------------
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) / /
(b) / /
-------------------------------------------------------------------------------
3. SEC Use Only
-------------------------------------------------------------------------------
4. Citizenship or Place of Organization United States of America
-------------------------------------------------------------------------------
5. Sole Voting Power 3,201,551
Number of Shares ------------------------------------------------------------
Beneficially 6. Shared Voting Power 34,400
Owned by Each ------------------------------------------------------------
Reporting Person 7. Sole Dispositive Power 3,201,551
With ------------------------------------------------------------
8. Shared Dispositive Power 34,400
-------------------------------------------------------------------------------
9. Aggregate Amount Beneficially Owned by Each Reporting Person
3,235,951
-------------------------------------------------------------------------------
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares
(See Instructions)
-------------------------------------------------------------------------------
11. Percent of Class Represented by Amount in Row (9) 12.1%
-------------------------------------------------------------------------------
12. Type of Reporting Person (See Instructions)
T. William Hutchens - IN
-------------------------------------------------------------------------------
Schedule 13G Page 3 of 5
ITEM 1.
(a) Ciphergen Biosystems, Inc., a Delaware corporation
(b) 6611 Dumbarton Circle, Fremont, CA 94555
ITEM 2.
(a) T. William Hutchens
(b) 132 Palmer Avenue, Mountain View, CA 94043
(c) United States of America
(d) Common Stock
(e) 17252Y 10 4
ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO SECTION 240.13d-1(b) OR
240.13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A:
Not Applicable.
ITEM 4. OWNERSHIP
(a) Amount beneficially owned: 3,235,951 shares
(b) Percent of class: 12.1%
(c) Number of shares as to which the person has:
(i) Sole power to vote or to direct the vote: 3,201,551 shares
(ii) Shared power to vote or to direct the vote: 34,400
(iii) Sole power to dispose or to direct the disposition of:
3,201,551
(iv) Shared power to dispose or to direct the disposition of:
34,400 shares
ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS
Not Applicable.
ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON
Not Applicable.
Schedule 13G Page 4 of 5
ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE
SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY
Not Applicable.
ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP
Not Applicable.
ITEM 9. NOTICE OF DISSOLUTION OF GROUP
Not Applicable.
ITEM 10. CERTIFICATION
Not Applicable.
Schedule 13G Page 5 of 5
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I certify
that the information set forth in this statement is true, complete and correct.
FEBRUARY 13, 2001
----------------------------------------
Date
/s/ T. WILLIAM HUTCHENS
----------------------------------------
Signature
T. WILLIAM HUTCHENS
----------------------------------------
Name