5 1 hugobraun_form5for123101.txt FORM 5 FOR HUGO BRAUN FOR 12-31-01 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 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(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [_] Form 3 Holdings Reported [X] Form 4 Transactions Reported ________________________________________________________________________________ 1. Name and Address of Reporting Person* Braun Hugo E. -------------------------------------------------------------------------------- (Last) (First) (Middle) 5840 Interface Drive -------------------------------------------------------------------------------- (Street) Ann Arbor Michigan 48103 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Nematron Corporation NMN ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year 12/31/2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person 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) [_] 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 ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. 3. ----------------------------- of Issuer's (D) or Indirect 1. Transaction Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* 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. (Print or Type Responses) (Over) FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Warrants to purchase Common Common Stock $0.30 03/23/01 P 500,000 03/23/01 03/31/06 Stock 500,000 $0.30 500,000 I (1) ------------------------------------------------------------------------------------------------------------------------------------ Rights to convert subordinated note J-1 Common to Common Stock $0.30 09/01/01 J-2 2,500,000 09/01/01 (2) Stock 2,500,000 $0.30 0 I (1) ------------------------------------------------------------------------------------------------------------------------------------ Rights to convert subordinated note Common to Common Stock $0.18 12/29/01 J-2 1,666,666 09/01/01 (2) Stock 2,500,000 $0.18 4,166,666 I (1) ------------------------------------------------------------------------------------------------------------------------------------ Warrants to purchase Common Common Stock Stock 131,785 I (3) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: J-1 Right to convert note to Common Stock at $0.30 per share. On September 1, 2001, this right became effective due to the issuer, Nematron Corporation, not complete a private equity offering by August 31, 2001. J-2 The right to convert note to Common Stock issued on 09/01/01 contained a provision whereby the number of shares that could be acquired was adjusted upward if the closing price of Nematron's Common Stock was less than $0.30 per share for five consecutive trading days. As of December 29, 2001, the closing price of the underlying equity security was $0.18, so that the number of shares that could be acquired increased from 2,500,000 to 4,166,666, and increase of 1,666,666 shares. (1) Warrants and subordinated note giving rise to the right to convert the principal balance of a subordinated note ($750,000) were issued to North Coast Technology Investors, LP, of which Mr. Braun is a partner. (2) The rights continue until the principal balance of the note is paid in full or until the note is converted to Common Stock. (3) Warrants issued to Onset BIDCO, of which Mr. Braun is a partner. /s/ Hugo E. Braun 04/05/02 --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). 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