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FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL
------ WASHINGTON, D.C. 20549 -------------------------------
OMB Number 3235-0362
|_| Check box if no ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Expires: January 31, 2005
longer subject Estimated average burden
to Section 16. Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, hours per response........1.0
Form 4 or Form 5 Section 17(a) of the Public Utility Holding Company Act of 1935 -------------------------------
obligations may or Section 30(h) of the Investment Company Act of 1940
continue. See
Instruction 1(b)
|_| Form 3 Holdings Reported
|X| Form 4 Transactions Reported
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1.Name and Address of Reporting Person* 2.Issuer Name AND Ticker or Trading Symbol 6.Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Atkins William T. AmeriVest Properties, Inc. (AMV) X Director X 10% Owner
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(Last) (First) (Middle) 3.IRS or Social Security 4.Statement for X Officer (give Other (specify
Number of Reporting Month/Day/Year --- title below) --- below)
Person, if an entity
(Voluntary) 9/29/00 CEO
1780 South Bellaire Street, Suite 515 ---------------------------
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(Street) 5.If Amendment, 7.Individual or Joint/Group Filing
Date of Original (Check applicable line)
(Month/Day/Year) Form filed by One Reporting Person
Denver Colorado 80222 ---
----------------------------------------- Form filed by More than One
(City) (State) (Zip) --- 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- 2A.Deemed 3.Transaction 4.Securities Acquired (A) 5.Amount of 6.Ownership 7.Nature of
(Instr. 3) action Execu- Code or Disposed of (D) Securities Form: Indirect
Date tion Date (Instr. 8) (Instr. 3, 4 and 5) Beneficially Direct Beneficial
(if any) ------------------------------- Owned at the (D) or Ownership
(Month/ (Month/ End of Issuer's Indirect (Instr. 4)
Day/ Day/ Amount (A) or Price Fiscal Year (I)
Year) Year) (D) (Instr. 3 and 4) (Instr. 4)
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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 4(b)(v).
(Over)
SEC 2270 (10-02)
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. Title of Derivative 2. Conver- 3. Trans- 3A. Deemed 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount
Security sion or action Execu- action Derivative cisable and of Underlying
(Instr. 3) Exercise Date tion Code Securities Expiration Securities
Price of Date, (Instr. 8) Acquired (A) or Date (Instr. 3 and 4)
Deriv- (Month/ if any Disposed of (D) (Month/Day/
ative Day/ (Instr. 3, 4, Year)
Security Year) (Month/ and 5)
Day/ -------------------------------------------------------
Year) Date Expira- Amount or
(A) (D) Exer- tion Title Number of
cisable Date Shares
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Common Stock Common
Warrants $5.00 9/29/00 S I 01/01/03 12/31/05 Stock 15,000
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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. Title of Derivative 8. Price 9. Number of 10. Ownership 11. Nature of
Security of Derivative of Indirect
(Instr. 3) Deriv- Securities Derivative Beneficial
ative Beneficially Security: Ownership
Security Owned at End Direct (D) or (Instr. 4)
(Insr. 5) of Year Indirect (I)
(Instr. 4) (Instr. 4)
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Common Stock
Warrants (a) 735,000 I (b)
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Explanation of Responses:
(a) Warrants owned by limited liability company in which reporting person has an indirect pecuniary
interest. Reporting person disclaims beneficial ownership over 588,000 warrants.
(b) Warrants transferred to third party in connection with a severance agreement. Closing price of
underlying common stock on last trading day before transaction on first trading day after transfer
was $4.50 per share.
/s/ DEBORAH J. FRIEDMAN February 13, 2003
** Intentional misstatements or omissions of facts ---------------------------- ------------------
constitute Federal Criminal Violations. ** Deborah J. Friedman Date
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Attorney-in-Fact
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. Page 2