-----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, PD8qTMHpTJM36p1ImyUyyek6GDHaym6+M9/D01CA/Jjn2c9n+CJYelMj7Aabnj4f M4b7pi1bnijp79U0cVaJAA== 0001021408-02-002488.txt : 20020414 0001021408-02-002488.hdr.sgml : 20020414 ACCESSION NUMBER: 0001021408-02-002488 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020215 COMPANY DATA: COMPANY CONFORMED NAME: BARLAS NED E CENTRAL INDEX KEY: 0001107276 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 8007000362 MAIL ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY CITY: MALVERN STATE: PA ZIP: 19355-1308 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AXEDA SYSTEMS INC CENTRAL INDEX KEY: 0001052593 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 770457660 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26287 FILM NUMBER: 02551362 BUSINESS ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 8007000362 MAIL ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY CITY: MALVERN STATE: PA ZIP: 19355-1308 FORMER COMPANY: FORMER CONFORMED NAME: DIVICORE INC DATE OF NAME CHANGE: 19990428 FORMER COMPANY: FORMER CONFORMED NAME: RAVISENT TECHNOLOGIES INC DATE OF NAME CHANGE: 19990617 FORMER COMPANY: FORMER CONFORMED NAME: QUADRANT INTERNATIONAL INC DATE OF NAME CHANGE: 19990323 5 1 d5.txt FORM 5 FOR NED BARLAS /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0362 / / Expires:...December 31, 2001 / / Estimated average burden / / hours per response...... 1.0 / /------------------------------/ +--------+ UNITED STATES | FORM 5 | SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 [_] Form 3 Holdings Reported [_] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Barlas Ned E. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Axeda Systems Inc. 257 Great Valley Parkway - -------------------------------------------------------------------------------- (Street) Malvern PA 19355 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Axeda Systems Inc (XEDA) ----------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) -------------- 4. Statement for Month/Year 12/2001 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [_] Director [x] Officer [_] 10% Owner [_] Other (give title below) (specify below) Senior Vice President and Chief Legal Officer 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 (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) Owned at Direct Bene- Day/ End of (D) or ficial Year) ----------------------------- Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 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 control number. SEC 2270 (3-99) 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. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------- (A) (D) - ----------------------------------------------------------------------------------------------------------------------------- Options to Acquire Common 7.81 7/19/00 A 12,000 Stock/1/ - ----------------------------------------------------------------------------------------------------------------------------- Options to Acquire Common 2.15 06/05/01 A 1,000 Stock/2/ - ----------------------------------------------------------------------------------------------------------------------------- Options to Acquire Common 0.01 6/20/01 A 50,000 Stock/3/ - ----------------------------------------------------------------------------------------------------------------------------- Options to Acquire Common 2.00 12/7/01 A 25,000 Stock/1/ - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Title Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ 7/19/04 7/18/10 Common 12,000 7.81 (D) - - ------------------------------------------------------------------------------------------------------------------------------------ 6/5/02 6/4/11 Common 1,000 2.15 (D) - - ------------------------------------------------------------------------------------------------------------------------------------ 6/20/02 6/19/11 Common 50,000 0.01 (D) - ------------------------------------------------------------------------------------------------------------------------------------ 12/07/05 12/6/11 Common 25,000 2.00 131,833 (D) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /1/ These options vest as follows: 25% after one year and the remainder in equal installments over 36 months (1/36 per month). /2/ These options will vest as follows: full vesting after one year of the vesting commencement date /3/ These options will vest as follows: vesting over a one year period on a monthly basis (1/12 per month) -------------------------------- ----------------- **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. 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 control number. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----