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FORM 5
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/ / Check box if no U.S. SECURITIES AND EXCHANGE COMMISSION ------------------------------------
longer subject to WASHINGTON, D.C. 20549 OMB APPROVAL
Section 16. Form ------------------------------------
4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0362
obligations may Expires: December 31, 2001
continue. See Filed pursuant to Section 16(a) of the Securities Estimated average burden
Instruction 1(b) Exchange Act of 1934, hours per response...............1.0
/ / 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 to
GOLDMAN, STEVEN F5 NETWORKS, INC (ffiv) Issuer (Check all applicable)
------------------------------------------- ---------------------------------------------- Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
501 ELLIOTT AVENUE WEST Number of Reporting Month/Year X Officer (give Other (specify
------------------------------------------- Person (Voluntary) SEPTEMBER 30, 2000 ---- title --- below)
(Street) ------------------- below)
SEATTLE, WA 98119 5. If Amendment, SENIOR VICE PRESIDENT OF SALES
------------------------------------------- Date of Original AND SERVICES
(City) (State) (Zip) (Month/Year) -------------------------------
7. Ind
------------------ (Check applicable line)
X Form Filed by one
---- Reporting Person
Form Filed by more than
---- one Reporting Person
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TABLE 1 -- 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
(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)
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COMMON STOCK 05/31/00 59,250 A $0.05 105,970 D
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*If the form is filed by more than one Reporting Person, see Instruction 4(b)(v).
POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM (Over)
ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. SEC 2270 (3-99)
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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 Title Number of
(A) (D) cisable Date Shares
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NON-QUALIFIED STOCK 05/31/00 M 14,250 COMMON 14,250 $0.05
OPTION (RIGHT TO BUY) STOCK
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NON-QUALIFIED STOCK 05/31/00 M 45,000 COMMON 45,000 $0.05
OPTION (RIGHT TO BUY) 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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D
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59,250 D
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Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Steven Goldman 11-21-00
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------ --------
**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.
Potential persons who are to respond to the collection of information contained in this form Page 2
are not required to respond unless the form displays a currently valid OMB Number. SEC 2270 (3-99)
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