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THIS DOCUMENT IS A COPY OF THE FORM 5 FILED ON FEBRUARY 18, 1998 PURSUANT TO
RULE 201 TEMPORARY HARDSHIP EXEMPTION.
OMB APPROVAL
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FORM 5 OMB Number 3235-0362
- ------ Expires: February 1, 1994
Estimated Average Burden
hours per response .... 1.0
/ / CHECK BOX IF NO U.S. SECURITIES AND EXCHANGE COMMISSION
LONGER SUBJECT TO WASHINGTON, DC 20549
SECTION 16. FORM
4 OR FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
OBLIGATIONS MAY
CONTINUE. SEE Filed pursuant to Section 16(a) of the Securities
INSTRUCTION 1(b) Exchange Act of 1934,
/X/ 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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<S> <C> <C> <C> <C> <C> <C>
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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
Issuer (Check all applicable)
Cottonwood Partnership Continental Natural Gas, Inc. ("CNGL")
- ------------------------------------------- ---------------------------------------------- Director X 10% Owner
(Last) (First) (Middle) 3. IRS Identification 4. Statement for ---- ---
1437 South Boulder, Suite 1250 Number of Reporting Month/Year Officer (give Other (specify
- ------------------------------------------- Person, if an Entity 12/97 ---- title --- below)
(Street) (Voluntary) ------------------- below)
Tulsa, Oklahoma 74119 5. If Amendment,
- ------------------------------------------- Date of Original -------------------------------
(City) (State) (Zip) (Month/Year)
7. Individual or Joint/Group Filing
------------------ (Check applicable line)
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. End of Issuer's Direct Benefi-
(Month/ 8) 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 8/1/97 3* 3,140,140 A* ** 3,140,140 D
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Common Stock 8/1/97 3* 297,864 A* ** 297,864 I ***
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*If the form is filed by more than one Reporting Person, see Instruction 4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(Print or Type Responses)
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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)
<S> <C> <C> <C> <C> <C> <C> <C>
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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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<S> <C> <C> <C>
1. Title of Derivative 9. Number of 10. Ownership 11. Nature of
Security Derivative of Derivative Indirect
(Instr. 3) Securities Security: Beneficial
Beneficially Direct (D) Ownership
Owned at End or Indirect (l) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
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Explanation of Responses:
* Initial public offering on August 1, 1997 triggered reporting obligation.
** $11.25 (assuming initial public offering price for issuer's common stock)
*** Held by Adams Affiliates, Inc., a wholly-owned subsidiary of Cottonwood Partnership.
COTTONWOOD PARTNERSHIP
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
/s/ Gary C. Adams 2/12/98
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- -------
**Signature of Reporting Person Date
By: Gary C. Adams
Chief Executive Officer
Note. File three copies of this Form, one of which must be manually signed. Page 2
If space provided is insufficient, see Instruction 6 for procedure. SEC 2270 (3/91)
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