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- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION -----------------------------
FORM 5 WASHINGTON, D.C. 20549 OMB APPROVAL
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/ / CHECK BOX IF NO LONGER ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0362
SUBJECT TO SECTION 16. EXPIRES: SEPTEMBER 30, 1998
FORM 4 OR FORM 5 OBLI- Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN
GATIONS MAY CONTINUE. Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 1.0
SEE INSTRUCTION 1(b). Section 30(f) of the Investment Company Act of 1940 -----------------------------
/ / FORM 3 HOLDINGS REPORTED
/ / FORM 4 TRANSACTIONS REPORTED
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
Teltone Corp. TTNC to Issuer (Check all applicable)
X Director X 10% Owner
Soshea Richard W ###-##-#### ---- ----
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- below)
Number of Reporting Month/Year below)
Person (Voluntary)
15138 141st Ave. SE 1997 --------------------------
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(Street) 5. If Amendment, 7. Individual or Joint/Group Reporting
Date of Original (check applicable line)
(Month/Year) X Form Filed by One Reporting Person
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Form filed by More than One
Reporting Person
Snohomish, Wa 98290 ---
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(City) (State) (Zip) TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) or 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action tion Disposed of (D) Securities ship Indirect
Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial
(Instr. 8) Owned at Direct Ownership
(Month/ end of (D) or (Instr. 4)
Day/ ------------------------------ Issuer's Indirect
Year) Amount (A) or Price Fiscal Year (I)
(D) (Instr. 3 (Instr. 4)
and 4)
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Teltone Common Stock 309,026 D
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Teltone Preferred Stock 27,272
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*If the form is filed by more than one reporting person, see instruction 4(b)(v). (Over)
SEC 2270 (7/97)
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.
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FORM 5 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative Security 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer-
(Instr. 3) sion of action action Derivative cisable and
Exercise Date Code Securities Ac- Expiration
Price of (Month/ (Instr. 8) quired (A) or Date
Deriv- Day/ Disposed of Month/Day/
ative Year) (D) Year)
Security (Instr. 3, 4, and 5)
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Date Expir-
---------------------- Exer- ation
cisable Date
(A) (D)
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Option (right to buy) V (1) 8/14/98
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Option (right to buy) V (2) 8/14/98
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Option (right to buy) V (3) 10/29/02
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7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Na-
lying Securities of of Deriv- ship ture of
(Instr. 3 and 4) Deriv- ative of Indirect
ative Secur- Deriv- Bene-
Secur- ities ative ficial
ity Bene- Secur- Owner-
(Instr. ficially ity: ship
5) Owned Direct (Instr. 4)
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of Year or In-
Amount or (Instr. 4) direct
Title Number of (I)
Shares (Instr. 4)
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Common 200,000 $.51 200,000
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Common 200,000 $.51 200,000
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Common 40,000 $.50 10,000
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Explanation of Responses:
(1) Incentive Stock Option issued under Teltone Corp's 1981 Stock Option Plan. Plan exercisable
in installments of 20% on first 5 anniversary dates from date of grant.
(2) Incentive Stock Option issued under Teltone Corp's 1983 Stock Option Plan. Plan exercisable
in installments of 20% on first 5 anniversary dates from date of grant.
(3) ISO issued under Teltone Corp's 1992 Stock Option Plan, Exerc. at 25% per year on anniv. dates.
/s/ Richard W. Soshea Feb. 13, 1998
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**Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date
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. Page 2
SEC 2270 (7-97)
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