4 1 form4ambase011231.txt FORM 4 --------------- FORM 4 --------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 (Print or Type Responses) ----------------------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol Haywood George W. Ambase Corporation (ABCP) ----------------------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS or Social Security Number of Reporting 642 Second Street Person, (voluntary) ------------------------------------------ (Street) Brooklyn, New York 11215 ----------------------------------------------------------------------------------------------- (City) (State) (Zip) ----------------------------------------------------------------------------------------------- 4. Statement for Month/Year 5. If Amendment, Date of Original (Month/Day/Year) December 2001 ----------------------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer 7. Individual or Joint/Group Reporting (Check all Applicatble) (check applicable line) --------------------------------------------------- --------------------------------------- Director x 10% Owner X Form Filed by One Reporting Person ----- ----- ---- Officer (give Other (specify Form Filed by More than One Person ----- title below) ----- below) ---- ------------------------------- -----------------------------------------------------------------------------------------------

Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ---------------------------------------------------------------------------------------------- 1. Title of Security 2. Transaction Date (Month/Day/Year) (Instr.3) ---------------------------------------------------------------------------------------------- Common Stock 12/27/01 ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------

3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 8) (Instr. 3, 4 and 5) ---------------------------------------------------------------------------------------------- Code V Amount (A) or (D) Price ---------------------------------------------------------------------------------------------- P 101,000 A 1.04 ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 5. Amount of Securities Beneficially 6. Ownership Form: Direct (D) Owned at end of Month (Instr. 3 and 4) or Indirect (I) (Instr. 4) ---------------------------------------------------------------------------------------------- 4,507,500 D ---------------------------------------------------------------------------------------------- 356,975 I ---------------------------------------------------------------------------------------------- 49,000 I ---------------------------------------------------------------------------------------------- 60,000 I ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 7. Nature of Indirect Beneficial Ownership (Instr 4.) --------------------------------------- ---------------------------------------------------------------------------------------------- Owned by children ---------------------------------------------------------------------------------------------- Owned by spouse ---------------------------------------------------------------------------------------------- Owned jointly with mother ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 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). 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 control number. FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ---------------------------------------------------------------------------------------------- 1. Title of Derivative Security 2. Conversion or Exercise 3. Transaction Date (Instr. 3) Price of Derivative (Month/Day/Year) Security ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 4. Transaction Code 5. Number of Derivative 6. Date Exercisable and (Instr. 8) Securities Acquired Expiration Date of Derivative (A) or Disposed of (D) (Month/Day/Year) Security ---------------------------------------------------------------------------------------------- Code V (A) (D) Date Expiration Exercisable Date ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 7. Title and Amount of 8. Price of Derivative 9. Number of Derivative Underlying Securities Security (Instr. 5) Securities Beneficially (Instr. 3 and 4) Owned at End of Month (Instr. 4) ---------------------------------------------------------------------------------------------- Title Amount or Number of Shares --------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- 10. Ownership of Derivateive 11. Nature of Indirect Beneficial Security: Direct (D) or Ownership (Instr. 4) Indirect (I) (Instr. 4) ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------- Explanation of Responses: /s/ George W. Haywood 01/10/01 ----------------------------- -------------------- Signature of Reporting Person Date ** 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. 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