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OMB APPROVAL
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------ OMB Number: 3235-0362
FORM 5 Expires: December 31, 2001
------ Estimated average burden
hours per response.... 1.0
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] CHECK BOX IF NO
LONGER SUBJECT TO
SECTION 16. FORM
4 OR FORM 5
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
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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) to
Schaeffer Peter NEON Systems, Inc. (NESY) Issuer (Check all applicable)
------------------------------------------- --------------------------------------------- X Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (specify
14100 Southwest Frwy, Suite 500 Person (Voluntary) Fiscal year ended ---- title --- below)
------------------------------------------- 3/31/01 below)
(Street) -------------------- -------------------
5. If Amendment,
Sugar Land TX 77478 Date of Original -------------------------------
------------------------------------------- Month/Year)
(City) (State) (Zip) 7. Individual or Joint/Group Reporting
------------------ (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
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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
(Month/ (Instr. end of Issuer's Direct Benefi-
Day/ 8) Fiscal Year (D) or cial
Year) ---------------------------- (Instr. 3 and 4) Indirect Owner-
Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr. 4)
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*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
(Over)
SEC 2270 (3-99)
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 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)
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Date Expira- Amount or
--------------- Exer- tion Number of
(A) (D) cisable Date Title Shares
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Common Stock $20.938 4/1/00 A 75,000 (1) 4/1/10 Common 75,000
Stock
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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)
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6,500 D
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Explanation of Responses:
(1) Option granted under the issuer's 1999 Long-Term Incentive Plan and subsequently cancelled
pursuant to his termination as an officer of the Company effective February 28, 2001.
/s/ Peter Schaeffer** May 10, 2001
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**Signature of Reporting Person Date
*As Attorney-in-Fact
**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. Page 2
If space is insufficient, see Instruction 6 for procedure. SEC 2270 (3-99)
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.