5 1 e-8140.txt FORM 5 OF JOHN P. MORBECK ------ ------------------------------------- FORM 5 OMB APPROVAL ------ ------------------------------------- [ ] Check this box if no longer OMB Number 3235-0362 subject to Section 16. Form 4 Expires: December 31, 2001 or Form 5 obligations may continue. Estimated average burden See Instruction 1(b). hours per response.............. 1.0 [ ] Form 3 Holdings Reported ------------------------------------- [ ] Form 4 Transactions Reported UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 ================================================================================ 1. Name and Address of Reporting Person* Morbeck John P. -------------------------------------------------------------------------------- (Last) (First) (Middle) 3323 One Union Square, 600 University Street -------------------------------------------------------------------------------- (Street) Seattle Washington 98101 -------------------------------------------------------------------------------- (City (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol International FiberCom, Inc. (IFCI) ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) ================================================================================ 4. Statement for Month/Year April 2001 ================================================================================ 5. If Amendment, Date of Original (Month/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 of (Instr. 3) action action or Disposed of (D) Securities Ben- ship Indirect Date Code (Instr. 3, 4 and 5) eficially Owned Form: Di- Beneficial (Month/ (Instr.8) ------------------------ at end of rect (D) Ownership Day/ (A) or Issuer's Fiscal or Indi- (Instr. 4) Year) Amount (D) Price Year (Instr. 3 rect (I) and 4) (Instr. 4) ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ================================================================================================================= * If the form is filed by more than one reporting person, see Instruction 4(b)(v). Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. ================================================================================================= Table II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) ================================================================================================================= 1.Title of Derivative Security 2.Conver- 3.Trans- 4.Transac- 5.Number of Deriva- (Instr. 3) sion or action tion tive Securities Exer- Date Code Acquired (A) or cise (Month/ (Instr.8) Disposed of (D) Price of Day/ (Instr. 3,4, and 5) Deriva- Year) tive Se- ------------------- curity (A) (D) ----------------------------------------------------------------------------------------------------------------- Stock Option (Right to Buy) $2.00 4/3/01 A4 20,000 ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ================================================================================================================= 6.Date Exercis- 7.Title and Amount of 8.Price 9.Number 10.Owner- 11.Nature able and Expi- Underlying Securities of of De- ship of of Indi- ration Date (Instr. 3 and 4) De- rivative Deriva- rect Ben- (Month/Day/ riva- Securi- tive Se- eficial Year) tive ties Ben- curity: Owner- -------------------- ---------------------- Secu- eficially Direct ship Date Expira- Amount or rity Owned at (D) or (Instr.4) Exer- tion Number of (Instr. 5) End of Year Indirect cisable Date Title Shares Year(Instr.4) (I)(Instr.4) ----------------------------------------------------------------------------------------------------------------- 4/3/01 4/2/06 Common Stock 20,000 20,000 D ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------- =================================================================================================================
Explanation of Responses: /s/ John P. Morbeck February 14, 2002 ------------------------------- ----------------- **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).