FORM 4
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. SEE Instruction 1(b).
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
OMB APPROVAL
OMB NUMBER: 3235-0287
EXPIRES: April 30,1997
ESTIMATED AVERAGE BURDEN
HOURS PER RESPONSE: 0.5
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1. Name and Address of Reporting Person
FRITZ CHARLES W.
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(Last) (First) (Middle)
2201 SECOND STREET, SUITE 600
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(Street)
FORT MYERS FLORIDA 33901
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(City) (State) (Zip)
NEOMEDIA TECHNOLOGIES, INC. (NEOM)
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2. Issuer Name and Ticker or Trading Symbol
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3. IRS or Social Security Number or Reporting Person (Voluntary)
12/97
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4. Statement for Month/Year
12/97
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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 [X] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
President, Chief Executive Officer and Chairman of the Board
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<TABLE>
<CAPTION>
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
<S> <C> <C> <C> <C> <C> <C>
6. OWNERSHIP 7. NATURE OF
5. AMOUNT OF SECURITIES FORM: INDIRECT
1. TITLE OF 2. TRANSACTION 3. TRANSACTION 4. SECURITIES ACQUIRED (A) BENEFICIALLY OWNED DIRECT (D) OR BENEFICIAL
SECURITY DATE CODE OR DISPOSED OF (D) AT END OF MONTH INDIRECT (I) OWNERSHIP
(INSTR. 3) (MONTH/DAY/YEAR) (INSTR. 8) (INSTR. 3, 4, AND 5) (INSTR. 3 AND 4) (INSTR. 4) (INSTR. 4)
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Code V Amount (A) or (D) Price
---- --- ------ -------- --------
Common Stock,
par value $.01 1,577,969 D
Common Stock,
par value $.01 12/01/97 X 50 A $369 100 I minor child
Common Stock,
par value $.01 12/01/97 X 50 A $369 100 I minor child
Common Stock,
par value $.01 12/01/97 X 50 A $369 100 I minor child
Common Stock,
par value $.01 12/01/97 X 50 A $369 100 I minor child
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
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<PAGE>
<TABLE>
<CAPTION>
TABLE II-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C>
5. NUMBER OF DERIVATIVE
SECURITIES ACQUIRED
1. TITLE OF DERIVATIVE 2. CONVERSION OR EXERCISE 3. TRANSACTION DATE 4. TRANSACTION (A) OR DISPOSED OF (D)
SECURITY (INSTR. 3) PRICE OF DERIVATIVE SECURITY (MONTH/ DAY/ YEAR) CODE (INSTR. 8) (INSTR. 3, 4, AND 5)
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Code V (A) (D)
---- --- --- ------
Warrants to purchase $8.85(a)
Warrants to purchase $7.375 12/01/97 X 50
Warrants to purchase $7.375 12/01/97 X 50
Warrants to purchase $7.375 12/01/97 X 50
Warrants to purchase $7.375 12/01/97 X 50
Warrants to purchase $7.875 12/11/97 J 300,000
</TABLE>
<TABLE>
<CAPTION>
TABLE II-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALY OWNED--(CONTINUED)
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C>
10. OWNERSHIP
FORM OF
7. TITLE AND DERIVATIVE 11. NATURE OF
AMOUNT OF 8. PRICE OF 9. NUMBER OF SECURITY: INDIRECT
6. DATE EXERCISABLE UNDERLYING DERIVATIVE DERIVATIVE SECURITIES DIRECT (D) OR BENEFICIAL
AND EXPIRATION DATE SECURITIES SECURITY BENEFICIALLY OWNED AT INDIRECT (I) OWNERSHIP
(MONTH/DAY/YEAR) (INSTR. 3 AND 4) (INSTR. 5) END OF MONTH (INSTR. 4) (INSTR. 4) (INSTR. 4)
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Amount
Date Expiration or Number
Exercisable Date Title of Shares
Common
9/16/97(b) 11/21/2001 Stock $0 114,000 D
Common
11/25/96 11/25/2001 Stock 50 $.10 0 I minor child
Common
11/25/96 11/25/2001 Stock 50 $.10 0 I minor child
Common
11/25/96 11/25/2001 Stock 50 $.10 0 I minor child
Common
11/25/96 11/25/2001 Stock 50 $.10 0 I minor child
Common
12/11/97 12/11/2002 Stock 300,000 $0 300,000 D
</TABLE>
EXPLANATION OF RESPONSES:
(a) Exercisable at 150% of the Initial Public Offering Price of the Company's
Common Stock in its Initial Public Offering of securities.
(b) Amended to 9/16/97 from 11/21/97.
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. Sec. 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ CHARLES W. FRITZ 01/05/98
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** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure.
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
FORM 4
(Continuation Sheet)
Item 1. Name:
Item 2. Issuer:
Item 3. Social Security Number:
Item 4. Statement of Month of:
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Explanation of Responses:
Table 1:
Table 2:
THE FILING OF THIS STATEMENT SHALL NOT BE CONSTRUED AS AN ADMISSION THAT THE
REPORTING PERSON IS, FOR THE PURPOSES OF SECTION 16 OF THE SECURITIES EXCHANGE
ACT OF 1934, AS AMENDED, THE BENEFICIAL OWNER OF ANY EQUITY SECURITIES COVERED
BY THIS STATEMENT.
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