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FORM 5
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[ ] Check this box if no U.S. SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL
longer subject to WASHINGTON, D.C. 20549 ----------------------------
Section 16. Form OMB Number: 3235-0362
4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Expires: December 31, 2001
obligations may Estimated average burden
continue. See Filed pursuant to Section 16(a) of the Securities hours per response......1.0
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
[X] 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)
HUSSEY, JEFFREY S F5 NETWORKS, INC. (FFIV) to Issuer (Check all applicable)
------------------------------------------- ---------------------------------------------- X Director X 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
C/O F5 NETWORKS, INC. Number of Reporting Month/Year Officer (give X Other (specify
401 ELLIOTT AVENUE WEST Person (Voluntary) SEPTEMBER 30, 2001 ---- title --- below)
------------------------------------------- ------------------- below)
(Street) 5. If Amendment, CHAIRMAN OF THE BOARD & CHIEF
SEATTLE, WA 98119 Date of Original STRATEGIST
------------------------------------------- (Month/Year) -------------------------------
(City) (State) (Zip) 7. Individual or Joint/Group Filing
------------------ (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 12/19/00 G4 50,000 D 2,250,000 D
(1)
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COMMON
STOCK
350,000 I BY Trust
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*If the form is filed by more than one reporting person, see Instruction 4(b)(v). PAGE 1 OF 3 PAGES (Over)
POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED SEC 2270 (3-99)
TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER.
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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9. Number of 10. Ownership Form 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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Explanation of Responses:
(1) SHARES WERE GIFTED TO THE HUSSEY FOUNDATION. THE REPORTING PERSON DISCLAIMS
ANY BENEFICIAL OWNERSHIP OF THESE SHARES.
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ JEFFREY HUSSEY 12/13/01
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 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 (3-99)