-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Q8GOzJvWouN4DUZWghWbmCBzPsoK54DTa8nSxJMG4mj51qsOFy57YdTACbJEbnd1 Fz32oLlWLhAC2p80E/A1xQ== 0001005757-02-000003.txt : 20020414 0001005757-02-000003.hdr.sgml : 20020414 ACCESSION NUMBER: 0001005757-02-000003 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020131 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CSG SYSTEMS INTERNATIONAL INC CENTRAL INDEX KEY: 0001005757 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 470783182 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27512 FILM NUMBER: 02523233 BUSINESS ADDRESS: STREET 1: 7887 EAST BELLEVIEW AVE STREET 2: SUITE 1000 CITY: ENGLEWOOD STATE: CO ZIP: 80111 BUSINESS PHONE: 3037962850 MAIL ADDRESS: STREET 1: 7887 E. BELLVIEW AVE. STREET 2: SUITE 1000 CITY: ENGLEWOOD STATE: CO ZIP: 80111 COMPANY DATA: COMPANY CONFORMED NAME: HANSEN NEAL C CENTRAL INDEX KEY: 0001031871 OFFICER IRS NUMBER: 507521673 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O CSG SYSTEMS INTERNATIONAL INC (CSGS) STREET 2: 7887 E BELLEVIEW AVE SUITE 1000 CITY: ENGLEWOOD STATE: CO ZIP: 80111 BUSINESS PHONE: 3037962860 MAIL ADDRESS: STREET 1: C/O CSG SYSTEMS INTERNATIONAL INC(CSGS) STREET 2: 7887 E BELLEVIEW AVE SUITE 1000 CITY: ENGLEWOOD STATE: CO ZIP: 80111 5 1 nhansen12312001form5.txt NEAL HANSEN FORM 5 12/31/01 1. Name and Address of Reporting Person HANSEN, NEAL C. 7887 E. Belleview Avenue Suite 1000 Englewood, CO 80111 USA 2. Issuer Name and Ticker or Trading Symbol CSG Systems International, Inc. (CSGS) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 2001 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) (X) Other (specify below) Chairman & CEO 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person TABLE I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
+---------------------------------+----------+-------------+-----------------------------+----------------+-----------+------------+ |1. Title of Security |2. Trans- |3. Trans- |4. Securities Acquired (A) |5. Amount of |6. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ | +-----------+------+----------+ Year | Indirect| Owner- | | | Year) | |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------------+-----------+------+----------+----------------+-----------+------------+ Common Stock 1060129 D Common Stock 435000 I Partnership Common Stock 63408 I Spouse
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ | +-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) | |(A) |(D) |cisable |tion Date |Title |Shares |Security |Year |(I) |ship | +-------------+--------+----------+---------+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Stock Options $9.6875 01/28/2007 Common 115900 D (Right to buy) Stock Stock Options $21.125 01/20/2008 Common 80000 D (Right to buy) Stock Stock Options $26.7188 11/17/2008 Common 400000 D (Right to buy) Stock Stock Options $34.43 12/14/2001 A 38000 12/14/2002 12/14/2011 Common 380000 $0.0000 380000 D (Right to buy) 0 Stock Stock Options $35.875 01/14/2009 Common 80000 D (Right to buy) Stock Stock Options $38.4375 01/07/2010 Common 60000 D (Right to buy) Stock Stock Options $47 01/17/2011 Common 100000 D (Right to buy) Stock Explanation of Responses: This stock option is exercisable in 4 installments of 76,000; 101,333; 101,333 and 101,334 shares each, respectively beginning on December 14, 2002.
SIGNATURE OF REPORTING PERSON /s/ NEAL C. HANSEN DATE 01/31/2002 -----END PRIVACY-ENHANCED MESSAGE-----