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FORM 5 OMB APPROVAL
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[ ] Check this box if no longer OMB Number 3235-0362
subject to Section 16. Form 4 Expires: October 31, 2001
or Form 5 obligations may continue. Estimated average burden
See Instruction 1(b). hours per response.............. 1.0
[ ] Form 3 Holdings Reported -------------------------------------
[ ] Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
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1. Name and Address of Reporting Person*
Ham Consulting Company (a)
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(Last) (First) (Middle)
3800 Old Cheney Road, Suite 101-222
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(Street)
Lincoln NE 68516
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(City (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Millenium Holding Group Inc. (MNHG)
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3. I.R.S. Identification Number of Reporting
Person, if an entity (Voluntary)
Ham Consulting Company 47 0750341
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4. Statement for Month/Year
Year end December 31, 1999
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5. If Amendment, Date of Original
(Month/Year)
Not Applicable
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[X] Director [X] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
Mr. Ham as the beneficial owner of Ham Consulting is a Director and Officer
(President) of the issuer
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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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<PAGE>
<TABLE>
<CAPTION>
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TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) or 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action action Disposed of (D) Securities Ben- ship Indirect
Date Code (Instr. 3, 4 and 5) eficially Owned Form: Di- Beneficial
(Month/ (Instr.8) at end of rect (D) Ownership
Day/ ---------------------------- Issuer's Fiscal or Indi- (Instr. 4)
Year) (A) or Year rect (I)
Amount (D) Price (Instr. 3 and 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 06/30/94 P/K 456,791 A 456,791 D
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* If the form is filed by more than one reporting person, see Instruction
4(b)(v). 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.
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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 Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriva-
(Instr. 3) sion or action tion tive Securities Ac-
Exer- Date Code quired (A) or Dis-
cise (Month/ (Instr.8) posed of (D)
Price of Day/ (Instr. 3,4, and 5)
Deriva- Year)
tive Se- -------------------
curity (A) (D)
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6. Date Exercis- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Nature
able and Expi- Underlying Securities of of De- ship of of Indi-
ration Date (Instr. 3 and 4) De- rivative Deriva- rect Ben-
(Month/Day/ riva- Securi- tive Se- efcial
Year) tive ies Ben- curity: Owner-
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Date Expira- Amount or ity Owned at (D) or (Instr.4)
Exer- tion Number of (Instr. 5) End of Year Indirect
cisable Date Title Shares Year(Instr.4) (I)(Instr.4)
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</TABLE>
Explanation of Responses:
(a) Richard L. Ham is the controlling shareholder and director of Ham Consulting
and is also the president and controlling shareholder of the issuer.
Ham Consulting Company
/s/ Richard L. Ham 3/22/00
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Richard L. Ham, President Date
**Signature of Reporting Person
**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 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.
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