Form 5
FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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(h) of the Investment Company Act of 1940

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Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b).
Form 3 Holdings Reported
Form 4 Transactions Reported

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1. Name and Address of Reporting Person*
Herschkowitz, Samuel
2. Issuer Name and Ticker or Trading Symbol
Delcath Systems, Inc. ("DCTH" (1) and "DCT" (2))

6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[X]    Director                                   [X]     10% Owner
[X]    Officer (give title below)    [ ]    Other (specify below)
Chief Technical Officer                        

(Last)             (First)            (Middle)

1100 Summer Street, 3rd Floor
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary)

4. Statement for Month/Year
December 2002
(Street)
Stamford, Connecticut 06905
5. If Amendment, Date of Original (Month/Year)
7. Individual or Joint/Group Filing
(Check Applicable Line)
[X]  Form filed by One Reporting Person
[_] Form filed by More than One Reporting Person
(City)             (State)             (Zip) Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security
(Instr. 3)

2. Trans-
action
Date
(mm/dd/yy)

2A.
Deemed
Execution
Date, if
any
(mm/dd/yy)
3. Transaction
Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year(Instr. 3 and 4) 6. Owner-
ship Form:
Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Amount (A)
or
(D)
Price
Common Stock, par value $0.01               18,238   
               180,805  Beneficial remainder interest in trustt 
                    
                    
                    
                    

* If the form is filed by more than one reporting person, see Instructions 4(b)(v).

 

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SEC 2270 (9-02)


FORM 5 (continued)
Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
 
1.Title of Derivative Security
(Instr.3)
2. Conversion or
Exercise
Price of
Derivative
Security
3. Transaction
Date
(Month/
Day/
Year)

3. A Deemed
Execution
Date, if Any
(Month/
Day/
Year)

4. Transaction Code
(Instr. 8)
5. Number of Derivative
Securities
Acquired (A) or Disposed of(D)
(Instr. 3, 4 and 5)
6. Date Exercisable
and Expiration Date
(Month/Day/Year)
7. Title and Amount of
Underlying Securities
(Instr. 3 and 4)
8. Price of
Derivative
Security
(Instr. 5)

9. Number of Derivative Securities Beneficially Owned at End of Year (Instr. 4)

10. Ownership of Derivative Security: Direct (D) or Indirect (I)  (Instr. 4) 11. Nature of Indirect Beneficial Ownership  (Instr. 4)
(A) (D) Date
Exercisable
Expiration
Date
Title Amount or
Number
of Shares
Options to buy  $4.93              (3)  1/04  Common Stock  51,757         
Options to buy  $2.90              (3)  1/04  Common Stock  32,779         
Incentive Stock Option (right to buy)  $3,3125              (3)  12/1/05  Common Stock  30,150         
Incentive Stock Option (right to buy)  $3.3125              (3)  1/1/06  Common Stock  30,150         
Incentive Stock Option (right to buy)  $3.3125              (4)  12/17/06  Common Stock  30,000         
Incentive Stock Option (right to buy)  $0.71  9/19/02    4A    30,000    (5)  9/19/07  Common Stock  30,000    204,836   
                               
Explanation of Responses: (1) Nasdaq symbol.
(2) Boston Stock Exchange Symbol.
(3) Currently exercisable.
(4) Exercisable as to 50% of the shares on 12/17/2002 and 50% on 12/17/2003.
(5) Exercisable as to 15,000 shares on the first anniversary of grant and in full on the second anniversary of grant through the expiration date.

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
.See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ SAMUEL HERSCHKOWITZ 
**Signature of Reporting Person
February 13  2003  
Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.

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