<PAGE> 1
- ------
FORM 5
- ------
/ / Check box if no U.S. SECURITIES AND EXCHANGE COMMISSION
longer subject to WASHINGTON, DC 20549
Section 16. Form
4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
obligations may
continue. See Filed pursuant to Section 16(a) of the Securities
Instruction 1(b) Exchange Act of 1934,
/ / Form 3 Holdings Section 17(a) of the Public Utility
Reported Holding Company Act of 1935 or Section 30(f) of
/ / Form 4 the Investment Company Act
Transactions of 1940
Reported
<TABLE>
<S><C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person(1) 2. Issuer Name and Ticker or Trading Symbol 7. Individual or Joint/Group Filing
(Check applicable line)
X Form filed by One Reporting
---- Person
Form Filed by More Than One
Lebolt Frederic Hollinger International Inc. - HLR ---- Reporting Person
- ---------------------------------------------------------------------------------------------
(Last) (First) (Middle) 3. IRS Identification 4. Statement for
Number of Reporting Month/Year
Person , if an Entity
c/o Hollinger International Inc. (Voluntary)
401 North Wabash, Suite 750 Fiscal Year 1999
- ------------------------------------------- -------------------
(Street) 5. If Amendment,
Chicago, IL 60611 Date of Original
- ------------------------------------------- (Month/Year)
(City) (State) (Zip)
6. Relationship of Reporting Person to
Issuer (Check all applicable)
Director 10% Owner
---- ---
X Officer (give Other (Specify
---- title --- below)
below)
Vice President-New Media
------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Instr. 8) End of Issuer's Direct Benefi-
(Month/ Fiscal Year (D) or cial
Day/ ---------------------------- (Instr. 3 and 4) Indirect Owner-
Year) Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr.
4)
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
4(b)(v).
<PAGE> 2
<TABLE>
<CAPTION>
FORM 5 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
Carl W. Vogt (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S><C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv-
Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative
Deriv- Day/ Disposed of (D) (Month/Day/ Secur-
ative Year) (Instr. 3, 4, Year) ity
Security and 5) (Instr. 5)
-----------------------------------
Date Expira- Amount or
--------------- Exer- tion Title Number of
(A) (D) cisable Date Shares
- ------------------------------------------------------------------------------------------------------------------------------------
Under 1997 Plan $15.06 2/23/98 (A) (2) (3) 2/22/08 Class A (2)
- ------------------------------------------------------------------------------------------------------------------------------------
Under 1997 Plan $15.06 2/26/99 (1) (2) (3) 2/22/08 Class A (2)
- ------------------------------------------------------------------------------------------------------------------------------------
Under 1997 Plan $12.25 2/26/99 (1) (2) (3) 2/25/09 Class A (2)
- ------------------------------------------------------------------------------------------------------------------------------------
Under 1997 Plan $11.63 2/12/99 (A) (4) (3) 2/11/09 Class A (4)
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
9. Number of 10. Ownership 11. Nature of
Derivative of Derivative Indirect
Securities Security: Beneficial
Beneficially Direct (D) Ownership
Owned at End or Indirect (I) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
- -------------------------------------------------------------------------------------------------------
0
- -------------------------------------------------------------------------------------------------------
10,000 D
- -------------------------------------------------------------------------------------------------------
15,000 D
- -------------------------------------------------------------------------------------------------------
0
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
Explanation of Responses:
(1) Company and Reporting Person agreed to cancel options originally granted to Reporting Person on
February 23, 1998. New options were granted to Reporting Person on February 26, 1999.
(2) 10,000
(3) These options were granted to the reporting person under the Company's 1997 Stock Incentive Plan on
the Transaction Date ("Grant Date"). 25% of the options become exercisable on each of the first,
second, third and fourth anniversaries of the Grant Date.
(4) 15,000
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Frederic Lebolt 1/06/00
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- --------
Signature of Reporting Person(1) Date
Note. File three copies of this form, one of which must be manually signed. Page 2
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.
</TABLE>
