5 1 form52001carlucci.txt FORM5 FOR CARLUCCI 1. Name and Address of Reporting Person Carlucci, Frank 35 Northeast Industrial Road Branford, CT 06405 2. Issuer Name and Ticker or Trading Symbol Neurogen Corporation (NRGN) 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) (X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) 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 | +---------------------------------+----------+-------------+-----------+------+----------+----------------+-----------+------------+
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 $30.9375 02/01/2001 A 5000 02/28/2001 02/01/2011 Common 5000 $30.9375 5000 D (Right to buy) Stock Explanation of Responses: This option vests and becomes exercisable in twelve equal monthly installments following the date of the option grant.
SIGNATURE OF REPORTING PERSON /s/ Frank Carlucci DATE 02/13/2002