4 1 0001.txt FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP FORM 4 OMB APPROVAL --------------------------- [ ] CHECK THIS BOX IF NO LONGER OMB NUMBER 3235-0287 SUBJECT TO SECTION 16. EXPIRES: FEBRUARY 1, 1994 FORM 4 OR FORM 5 OBLIGATIONS EXTIMATED AVERAGE BURDEN MAY CONTINUE. SEE INSTRUCTION HOURS PER RESPONSE......0.5 1(b). 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 William C. Bossung 9800 Camden Hills Avenue Las Vegas, Nevada 89145 -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Latin American Casinos, Inc. -------------------------------------------------------------------------------- 3. IRS or Social Security Number or Reporting Person (Voluntary) -------------------------------------------------------------------------------- 4. Statement for Month/Year November, 2000 -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [X] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Chief Operating Officer ---------------------------------------- -------------------------------------------------------------------------------- TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED --------------------------------------------------------------------------------
1. Title 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of of Security action action or Disposed of (D) Securities Ship Form: Indirect Bene- (Instr. 3) Date Code (Instr. 3, 4 and 5) Beneficially Direct (D) ficial Owner- (Month/ Instr.8) Owned at or Indirect ship Day/Year) -------------------------------------- End of Month (I) (Instr. 4) Code V Amount (A) or Price (Instr. 3 and 4) (Instr. 4) (D) -------------------------------------------------------------------------------------------------------------------------- Common Stock 11/22/00 J (See Below) 100,000(A) $1.75 639,403 I Alliance Financial Network, Inc. --------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) SEC 1474 (3/91) -------------------------------------------------------------------------------- TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) --------------------------------------------------------------------------------
1.Title 2.Conver- 3.Trans- 4.Transac- 5.Number 6.Date 7.Title and 8.Price 9.Number of 10.Owner- 11.Nature of Deriv- sion or action tion Code of Deriv- Exercise Amount of of Deriva- Derivative ship Form of Indir- ative Exercise Date (Instr. 8) ative Se- and Expir- Underlying tive Secur- Securities of Deriv- ect Bene- Security Price of (Month/ curities ation Date Securities ity (Instr. Beneficially ative Se- ficial (Instr. 3) Derivative Day/Year) Acquired (Month/Day/ (Instr. 5) Owned at End curity: Ownership Security (A) or Year) 3 & 4) of Month Direct (Instr. 4) Disposed --------------------------- (Instr. 4) (D) or of (D) Date Expir- Amt. or Indirect (Instr. Exer- ation Title Num. of (I) (Instr. 3, 4 & 5) cisable Date Shares 4) --------------------- Code V (A) (D) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: Shares acquired pursuant to employment arrangement. ** 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. /s/ WILLIAM C. BOSSUNG December 8, 2000 ---------------------------------- ---------------- William C. Bossung Date