-----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, UKkDnMmamuPrbHZIe7Ncd7418e0WPe+xTzDkSH/uocDq+8OMJ/vQwBQy4S5/iHAG Lwca4IjHtd9LQvY46kK7Fg== 0001016843-97-000646.txt : 19971211 0001016843-97-000646.hdr.sgml : 19971211 ACCESSION NUMBER: 0001016843-97-000646 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971201 FILED AS OF DATE: 19971210 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NEOMEDIA TECHNOLOGIES INC CENTRAL INDEX KEY: 0001022701 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 363680347 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-21743 FILM NUMBER: 97735556 BUSINESS ADDRESS: STREET 1: 2201 SECOND ST STE 600 STREET 2: STE 600 CITY: FORT MYERS STATE: FL ZIP: 33901 BUSINESS PHONE: 6303554404 MAIL ADDRESS: STREET 1: 2201 SECOND STREET STREET 2: SUITE 600 CITY: FORT MYERS STATE: FL ZIP: 33901 FORMER COMPANY: FORMER CONFORMED NAME: DEVSYS INC DATE OF NAME CHANGE: 19960911 COMPANY DATA: COMPANY CONFORMED NAME: FRITZ CHARLES W CENTRAL INDEX KEY: 0001046601 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O NEOMEDIA TECHNOLOGIES, INC STREET 2: 2201 SECIBD ST CITY: FORT MYERS STATE: FL ZIP: 33901 BUSINESS PHONE: 3127261224 MAIL ADDRESS: STREET 1: KLIMEK & ANDERSON, P.C. STREET 2: 30 N. LASALLE STREET, SUITE 3500 CITY: CHICAGO STATE: IL ZIP: 60602 4 1 FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. SEE Instruction 1(b). U.S. 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 OMB APPROVAL OMB NUMBER: 3235-0287 EXPIRES: April 30,1997 ESTIMATED AVERAGE BURDEN HOURS PER RESPONSE: 0.5 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person FRITZ CHARLES W. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 2201 SECOND STREET, SUITE 600 - -------------------------------------------------------------------------------- (Street) FORT MYERS FLORIDA 33901 - -------------------------------------------------------------------------------- (City) (State) (Zip) NEOMEDIA TECHNOLOGIES, INC. (NEOM) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol - -------------------------------------------------------------------------------- 3. IRS or Social Security Number or Reporting Person (Voluntary) 12/97 - -------------------------------------------------------------------------------- 4. Statement for Month/Year - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] 10% Owner [X] Officer (give title below) [ ] Other (specify below) President, Chief Executive Officer and Chairman of the Board - --------------------------------------------------------------------------------
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED 6. OWNERSHIP 7. NATURE OF 5. AMOUNT OF SECURITIES FORM: INDIRECT 1. TITLE OF 2. TRANSACTION 3. TRANSACTION 4. SECURITIES ACQUIRED (A) BENEFICIALLY OWNED DIRECT (D) OR BENEFICIAL SECURITY DATE CODE OR DISPOSED OF (D) AT END OF MONTH INDIRECT (I) OWNERSHIP (INSTR. 3) (MONTH/DAY/YEAR) (INSTR. 8) (INSTR. 3, 4, AND 5) (INSTR. 3 AND 4) (INSTR. 4) (INSTR. 4) - ---------------------------------------------------------------------------------------------------------------------------------- Code V Amount (A) or (D) Price ---- --- ------ -------- -------- Common Stock, par value $.01 1,577,969 D Common Stock, par value $.01 12/01/97 X 50 A $369 100 I minor child Common Stock, par value $.01 12/01/97 X 50 A $369 100 I minor child Common Stock, par value $.01 12/01/97 X 50 A $369 100 I minor child Common Stock, par value $.01 12/01/97 X 50 A $369 100 I minor child
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of 3
TABLE II-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 5. NUMBER OF DERIVATIVE SECURITIES ACQUIRED 1. TITLE OF DERIVATIVE 2. CONVERSION OR EXERCISE 3. TRANSACTION DATE 4. TRANSACTION (A) OR DISPOSED OF (D) SECURITY (INSTR. 3) PRICE OF DERIVATIVE SECURITY (MONTH/ DAY/ YEAR) CODE (INSTR. 8) (INSTR. 3, 4, AND 5) - ----------------------------------------------------------------------------------------------------------------------------------- Code V (A) (D) ---- --- --- ------ Warrants to purchase $8.85(a) Warrants to purchase $7.375 12/01/97 X 50 Warrants to purchase $7.375 12/01/97 X 50 Warrants to purchase $7.375 12/01/97 X 50 Warrants to purchase $7.375 12/01/97 X 50
TABLE II-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALY OWNED--(CONTINUED) (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 10. OWNERSHIP FORM OF 7. TITLE AND DERIVATIVE 11. NATURE OF AMOUNT OF 8. PRICE OF 9. NUMBER OF SECURITY: INDIRECT 6. DATE EXERCISABLE UNDERLYING DERIVATIVE DERIVATIVE SECURITIES DIRECT (D) OR BENEFICIAL AND EXPIRATION DATE SECURITIES SECURITY BENEFICIALLY OWNED AT INDIRECT (I) OWNERSHIP (MONTH/DAY/YEAR) (INSTR. 3 AND 4) (INSTR. 5) END OF MONTH (INSTR. 4) (INSTR. 4) (INSTR. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Amount Date Expiration or Number Exercisable Date Title of Shares Common 9/16/97(b) 11/21/2001 Stock $0 114,000 D Common 11/25/96 11/25/2001 Stock 50 $.10 0 I minor child Common 11/25/96 11/25/2001 Stock 50 $.10 0 I minor child Common 11/25/96 11/25/2001 Stock 50 $.10 0 I minor child Common 11/25/96 11/25/2001 Stock 50 $.10 0 I minor child
EXPLANATION OF RESPONSES: (a) Exercisable at 150% of the Initial Public Offering Price of the Company's Common Stock in its Initial Public Offering of securities. (b) Amended to 9/16/97 from 11/21/97. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. Sec. 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ CHARLES W. FRITZ 12/10/97 - ----------------------------------------- ----------------- ** Signature of Reporting Person 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. Page 2 of 3 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP FORM 4 (Continuation Sheet) Item 1. Name: Item 2. Issuer: Item 3. Social Security Number: Item 4. Statement of Month of: - ------------------------------------------------------------------------------- Explanation of Responses: Table 1: Table 2: THE FILING OF THIS STATEMENT SHALL NOT BE CONSTRUED AS AN ADMISSION THAT THE REPORTING PERSON IS, FOR THE PURPOSES OF SECTION 16 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED, THE BENEFICIAL OWNER OF ANY EQUITY SECURITIES COVERED BY THIS STATEMENT. Page 3 of 3 -----END PRIVACY-ENHANCED MESSAGE-----