-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, SslBwqAXETv+CyobVQRyyOBzXFL1b86fTKtEUsmhnC+aBpNGYz0tUhDll/PyiFvr C7ULqY5zJTjXyjhGiZwLoA== 0000903856-99-000011.txt : 19990217 0000903856-99-000011.hdr.sgml : 19990217 ACCESSION NUMBER: 0000903856-99-000011 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981231 FILED AS OF DATE: 19990216 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SODAK GAMING INC CENTRAL INDEX KEY: 0000903856 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-PROFESSIONAL & COMMERCIAL EQUIPMENT & SUPPLIES [5040] IRS NUMBER: 460407053 STATE OF INCORPORATION: SD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-21754 FILM NUMBER: 99541945 BUSINESS ADDRESS: STREET 1: 5301 S HWY 16 CITY: RAPID CITY STATE: SD ZIP: 57701 BUSINESS PHONE: 6053415400 MAIL ADDRESS: STREET 1: SODAK GAMING INC STREET 2: 5301 S HIGHWAY 16 CITY: RAPID CITY STATE: SD ZIP: 57701 COMPANY DATA: COMPANY CONFORMED NAME: LOPEZ RONNIE CENTRAL INDEX KEY: 0001066726 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR IRS NUMBER: 460407053 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O ANGIE LOPEZ STREET 2: 225 W. INDIAN SCHOOL RD. CITY: PHOENIX STATE: AZ ZIP: 85013 BUSINESS PHONE: 6053415400 5 1 FORM 5 ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0362 Expires: April 30, 1997 Estimated average burden hours per response ....... 1.0 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL 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 [ ] Check this box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [ ] Form 3 Holdings Reported [x ] Form 4 Transactions Reported ================================================================================ 1. Name and Address of Reporting Person Lopez Ronnie - -------------------------------------------------------------------------------- (Last) (First) (Middle) 411 North Central Avenue, Suite 520 - -------------------------------------------------------------------------------- (Street) Phoenix AZ 85004 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Sodak Gaming, Inc. (SODK) ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ================================================================================ 4. Statement for Month/Year December 1998 ================================================================================ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ x ] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) -------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Security Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. 3. ----------------------------- of Issuer's (D) or Indirect 1. Transaction Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (Instr. 8) (D) & 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock $.001 par value 1,075 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 10.875 J(7) 2,000 (1) Common 2,000 0 D (right to buy) 1/9/94 7/9/98 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 8.25 (2) Common 2,000 2,000 D (right to buy) 11/12/94 5/12/99 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 7.00 (3) Common 10,000 10,000 D (right to buy) 11/12/95 5/12/00 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 12.875 (4) Common 10,000 10,000 D (right to buy) 10/30/96 4/30/01 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 12.00 5/6/97 10,000 (5) Common 10,000 10,000 D (right to buy) 11/06/97 5/06/02 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 6.4375 5/7/98 10,000 (6) Common 10,000 10,000 D (right to buy) 11/07/98 5/07/03 Stock $.001 par value - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: 1. Grant to reporting person of option to buy 2,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. This option was previously reported as covering 1000 shares, but was adjusted to reflect a stock split on September 27, 1996. 2. Grant to reporting person of option to buy 2,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. This option was previously reported as covering 1000 shares, but was adjusted to reflect a stock split on September 27, 1996. 3. Grant to reporting person of option to buy 10,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. This option was previously reported as covering 5000 shares, but was adjusted to reflect a stock split on September 27, 1996. 4. Grant to reporting person of option to buy 10,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. This option was previously reported as covering 5000 shares, but was adjusted to reflect a stock split on September 27, 1996. 5. Grant to reporting person of option to buy 10,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. 6. Grant to reporting person of option to buy 10,000 shares of common stock under the Sodak Gaming, Inc. 1993 Non-Employee Director Option Plan in transaction exempt under Rule 16b-3. 7. Expiration of options in accordance with its terms. - --------------------------------------------- ----------------------- **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. -----END PRIVACY-ENHANCED MESSAGE-----