FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section
17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the
Investment Company Act of 1940
1. Name and Address of Reporting Person*
John A. Holmes III
520 SW Sixth Avenue, Suite 750
Portland, OR 97204-1556
2. Issuer Name and Ticker and Ticker or Trading Symbol
NBG Radio Network, Inc. (NSBD)
3. I.R.S. Identification Number of Reporting Person, if an entity
(Voluntary)
4. Statement for Month/Day/Year
1/22/03
5. If Amendment, Date of Original (Month/Day/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
/X/ Director
/X/ Officer (give title below)
President
/ / 10% Owner
/ / Other (specify below)
-----------------------------
7. Individual or Joint/Group Filing (Check Applicable Line)
/X/ Form filed by One Reporting Person
/ / Form filed by More than One Reporting Person
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).
FORM 4 (CONTINUED)
Table 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially
Owned
1. Title of Security (Instr. 3)
Common Stock
2. Transaction Date(s) (Month/Day/Year)
2A. Deemed Execution Date, if any (Month/Day/Year)
3. Transaction Code (Instr. 8)
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction
(Instr. 3 and 4)
248,732
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
D
7. Nature of Indirect Beneficial Ownership (Instr. 4)
FORM 4 (CONTINUED)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)
i. Employee Stock Option to Purchase Common Stock
ii. Employee Stock Option to Purchase Common Stock
iii. Employee Stock Option to Purchase Common Stock
iv. Employee Stock Option to Purchase Common Stock
v. Employee Stock Option to Purchase Common Stock
vi. Employee Stock Option to Purchase Common Stock
vii. Employee Stock Option to Purchase Common Stock
viii. Employee Stock Option to Purchase Common Stock
ix. Warrant to Purchase Common Stock
x. Employee Stock Option to Purchase Common Stock
xi. Employee Stock Option to Purchase Common Stock
2. Conversion or Exercise Price of Derivative Security
i. $0.04 per share
ii. $0.04 per share
iii. $0.04 per share
iv. $0.05 per share
v. $0.11 per share
vi. $0.11 per share
vii. $0.22 per share
viii. $0.65 per share
ix. $1.50 per share
x. $1.75 per share
xi. $0.54 per share
3. Transaction Date (Month/Day/Year)
i. 12/20/02
ii. 12/19/02
iii. 12/18/02
iv. 12/10/02
v. 11/05/02
vi.
vii.
viii.
ix.
x.
xi.
3A. Deemed Execution Date, if any (Month/Day/Year)
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
4. Transaction Code (Instr. 8)
i. Code: A
V:
i. Code: A
V:
ii. Code: A
V:
iii. Code: A
V:
iv. Code: A
V:
v. Code: A
V:
vi. Code:
V:
vii. Code:
V:
viii. Code:
V:
ix. Code:
V:
x. Code:
V:
xi. Code:
V:
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
i. 2,500 (A)
ii. 2,500 (A)
iii. 2,500 (A)
iv. 2,500 (A)
v. 2,500 (A)
vi.
vii.
viii.
ix.
x.
xi.
6. Date Exercisable and Expiration Date (Month/Day/Year)
i. Date Excercisable: 1/19/03
Expiration Date: 1/19/06
ii. Date Excercisable: 1/18/03
Expiration Date: 1/18/06
iii. Date Excercisable: 1/17/03
Expiration Date: 1/17/06
iv. Date Excercisable: 1/09/03
Expiration Date: 1/09/06
v. Date Excercisable: 12/05/02
Expiration Date: 12/05/05
vi. Date Excercisable: 10/17/02
Expiration Date: 10/17/05
vii. Date Excercisable: 09/04/02
Expiration Date: 09/04/05
viii. Date Excercisable: 05/11/02
Expiration Date: 05/11/05
ix. Date Excercisable: 09/05/01
Expiration Date: 03/05/03
x. Date Excercisable: 06/01/01
Expiration Date: 03/10/06
xi. Date Excercisable: 07/31/98
Expiration Date: 06/12/03
7. Title and Amount of Underlying Securities (Instr. 3 and 4)
i. Title: Common Stock
Amount: 2,500 shares
ii. Title: Common Stock
Amount: 2,500 shares
iii. Title: Common Stock
Amount: 2,500 shares
iv. Title: Common Stock
Amount: 2,500 shares
v. Title: Common Stock
Amount: 2,500 shares
vi. Title: Common Stock
Amount: 2,500 shares
vii. Title: Common Stock
Amount: 2,500 shares
viii. Title: Common Stock
Amount: 30,000 shares
ix. Title: Common Stock
Amount: 32,832 shares
x. Title: Common Stock
Amount: 500,000 shares
xi. Title: Common Stock
Amount: 407,000 shares
8. Price of Derivative Security (Instr. 5)
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
9. Number of Derivative Securities Beneficially Owned Following Reported
Transaction(s) (Instr. 4)
i. 2,500
ii. 2,500
iii. 2,500
iv. 2,500
v. 2,500
vi. 2,500
vii. 2,500
viii. 30,000
ix. 32,832
x. 500,000
xi. 407,000
FORM 4 (CONTINUED)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
i. D
ii. D
iii. D
iv. D
v. D
vi. D
vii. D
viii. D
ix. D
x. D
xi. D
11. Nature of Indirect Beneficial Ownership (Instr. 4)
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
Explanation of Responses:
/s/ JOHN J. BRUMFIELD 01/22/03
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John J. Brumfield
ATTORNEY-IN-FACT
** Signature of Reporting Person Date
**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. If
space provided is insufficient, see Instruction 6 for procedure.
Potential person(s) 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.