Newman Edward G. FORM 5
UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 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
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1. Name and Address of Reporting Person*
Newman Edward G.
(Last) (First) (Middle)
12701 Fair Lakes Circle, Suite 550
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(Street)
Fairfax, Virginia 22033
(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol Xybernaut Corporation ("XYBR")
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
December, 2002
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below)
President, Chief Executive Officer, Chairman
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7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [ ] Form filed by more than one Reporting Person
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-------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned --------------------------------------------------------------------------------
5. Amount of 6. Owner- 2A. 4. Securities Acquired (A) or Securities ship 7. Nature 2. Trans- Deemed 3. Trans- Disposed of (D) Beneficially Form: of action Execution action (Instr. 3, 4 and 5) Owned at End Direct Indirect Date Date, if Code -------------------------- of Issuer's (D) or Benefi- 1. Title (Month/ any Month/ (Instr.8) (A) Fiscal Indirect cial of Security Day/ Day/ or Year (Instr. (I) Ownership (Instr. 3) Year) Year) Amount (D) Price 3 and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.01 par value 12/17/02 J(1) 858,343 D $.615 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.01 par value 12/17/02 J(2) 250,000 D $.615 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.01 par value 903,245(3) D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, (4)(5)(6) $.01 par value 1,028,750 I (7)(8) ------------------------------------------------------------------------------------------------------------------------------------
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*If the form is filed by more than one reporting person see instruction 4(b)(v).
(Over)
SEC 2270 (9-02)
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TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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10. 9. Owner- Number ship of Form 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. 3A. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- Deemed 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Execution Trans- of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date Date, if action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ any Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Month/Day (Instr. ----------- Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $1.78 12/17/02 H(9) 41,665 Immed. 9/10/09 Stock 41,665 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $1.375 12/17/02 H(9) 61,994 Immed. 10/1/09 Stock 61,994 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $1.375 12/17/02 H(9) 213,006 Immed. 10/1/09 Stock 213,006 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $4.0938 12/17/02 H(9) 100,000 Immed. 12/3/09 Stock 100,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $4.8125 12/17/02 H(9) 50,000 Immed. 10/20/10 Stock 50,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $2.23 12/17/02 H(9) 202,158 Immed. 12/31/11 Stock 202,158 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $2.23 12/17/02 H(9) 38,226 Immed. 12/31/11 Stock 38,226 0 D ------------------------------------------------------------------------------------------------------------------------------------
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10. 9. Owner- Number ship of Form 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. 3A. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- Deemed 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Execution Trans- of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date Date, if action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ any Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Month/Day (Instr. ----------- Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $2.21 1/16/02 A 10,000 Immed. 1/16/12 Stock 10,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $0.24 10/25/02 A 15,000 (10) 10/24/12 Stock 15,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $0.61 12/17/02 A 10,000 Immed. 12/17/12 Stock 10,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $2.21 12/17/02 H(9) 10,000 Immed. 1/16/12 Stock 10,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $0.24 12/17/02 H(9) 15,000 (10) 10/24/12 Stock 15,000 0 D ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock, $.01 par value per Common share $0.61 12/17/02 H(9) 10,000 Immed. 12/17/12 Stock 10,000 0 D ====================================================================================================================================
-------------------------------------------------------------------------------- Explanation of Responses: (1) All of these shares were cancelled by the issueer to satisfy the Reporting Person's obligations to the issuer under that certain Promissory Note dated December 31, 2001.
(2) All of these shares, which shares were pledged to the issuer, were cancelled by the issuer to satisfy the the Reporting Person's obligations to the issuer under that certain Promissory Note dated December 31, 2001
(3) Includes 1,765 shares owned as joint tenants between the Reporting Person and his wife.
(4) Includes 200,000 shares owned by an irrevocable trust established by the Reporting Person for the benefit of his children. The Reporting Person disclaims beneficial ownership of all securities owned by his children and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
(5) Includes 761,950 shares owned by the Reporting Person's wife. The Reporting Person disclaims beneficial ownership of all securities owned by his wife and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
(5) Includes 9,000 shares owned by an irrevocable trust established by Dr. Steven A. Newman for which the Reporting Person is trustee.
(7) Includes 28,900 shares beneficially owned by an irrevocable trust established by the Reporting Person for the benefit of his sister. The Reporting Person disclaims beneficial ownership of all securities owned by his sister and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
(8) Includes 28,900 shares beneficially owned by an irrevocable trust established by the Reporting Person for the benefit of his mother. The Reporting Person disclaims beneficial ownership of all securities owned by his mother and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose.
(9) All of these options were cancelled by the issueer to satisfy the Reporting Person's obligations to the issuer under that certain Promissory Note dated December 31, 2001.
(10) 5,000 shares currently exercisable; Vests as to 5,000 shares on each of April 25, 2003 and October 25, 2003.
/s/ Edward G. Newman 2/14/03 ------------------------------------------- ----------------- **Signature of Reporting Person Date
* If the form is filed by more than one Reporting Person, see Instruction 4(b)(v).
** 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 number.
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