5 1 v69681e5.txt FORM 5 1 ------ FORM 5 -------------------------- ------ OMB APPROVAL -------------------------- OMB Number 3236-0362 [ ] Check box if no U.S. SECURITIES AND EXCHANGE COMMISSION Expires: December 31, 2001 longer subject to WASHINGTON, D.C. 20549 Estimated average burden Section 16. Form hours per response.....1.0 4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP -------------------------- obligations may continue. See Filed pursuant to Section 16(a) of the Securities Instruction 1(b) Exchange Act of 1934, [ ] Form 3 Holdings Section 17(a) of the Public Utility Reported Holding Company Act of 1935 or Section 30(f) of [X] Form 4 the Investment Company Act Transactions of 1940 Reported ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to TRANS COSMOS, INC. Primus Knowledge Solutions, Inc. (PKSI) Issuer (Check all applicable) ------------------------------------------- ---------------------------------------------- Director X 10% Owner (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- --- Sumitomo ??sernei Akaska Building, 3-3-3, Number of Reporting Month/Year Officer (give Other (specify Akasaka, Minato-ku Person (Voluntary) December 31, 2000 ---- title --- below) ------------------------------------------- ------------------- below) (Street) 5. If Amendment, TOKYO, JAPAN 107 Date of Original ------------------------------- ------------------------------------------- (Month/Year) (City) (State) (Zip) 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 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Month/ (Instr. 8) End of Issuer's Direct Benefi- Day/ Fiscal Year (D) or cial Year) --------------------------------------- (Instr. 3 and 4) Indirect Owner- Code Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/27/1999 P 66,667 A $5.999 1,935,285(1) (D)(1) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Includes 559,890 shares held directly by Trans Cosmos USA, Inc., 243,067 shares held directly by Encompass Group Inc., 857,329 shares held directly by U.S. Information Technology Financing, L.P., and 75,000 shares held directly by Primus KK. *If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) (Print or Type Responses) Page 1 of 2
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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) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) --------------------------------------------------- Date Expira- Amount or (A) (D) Exer- tion Title Number of cisable Date Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of 10. Ownership Form 11. Nature of Derivative of Derivative Indirect Securities Security: Beneficial Beneficially Direct (D) Ownership Owned at End or Indirect (I) (Instr. 4) of Year (Instr. 4) (Instr. 4) -------------------------------------------------------------------------- -------------------------------------------------------------------------- -------------------------------------------------------------------------- -------------------------------------------------------------------------- -------------------------------------------------------------------------- -------------------------------------------------------------------------- -------------------------------------------------------------------------- **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ YASUKI MATSUMOTO 2/14/2001 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- --------- **Signature of Reporting Person Date Yasuki Matsumoto, Vice President 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 2