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- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION -----------------------------
FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
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/X/ CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287
LONGER SUBJECT TO EXPIRES: SEPTEMBER 30, 1998
SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN
FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5
CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 -----------------------------
INSTRUCTION 1(b).
(Print or Type Responses)
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<S><C>
1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6.Relationship of Reporting Person(s)
to Issuer (Check all applicable)
USMX, Inc. (USMX- Nasdaq) Director 10% Owner
Cook Inlet Region, Inc. (USM - Toronto Exchange) ---- ----
- --------------------------------------------------------------------------------------------- Officer (give X Other
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify
Number of Reporting Month/Year below) below
2525 "C" Street Person (Voluntary) no longer owns shares
May, 1997 -------------------------------------
- -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing
(Street) 5. If Amendment, (Check Applicable Line)
Date of Original ---Form filed by One Reportng Person
92-0042304 (Month/Year) XX Form filed by More than One
---Reporting Person
Anchorage, Alaska 99503
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(City) (State) (Zip) 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) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Instr. 8) Owned at Direct Bene-
(Month/ End of (D) or ficial
Day/ ------------------------------------------- Month Indirect Owner-
Year) (A) or (I) ship
Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4)
and 4)
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Common Stock 5/30/97 J(1) 2,540,663 D (1) - 0 - I (2)
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (7-96)
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FORM 4 (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>
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1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer-
(Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex-
Exercise Date (Instr. 8) quired (A) or Dis- piration Date
Price of (Month/ posed of (D) (Month/Day/
Deriv- Day/ (Instr. 3, 4, and 5) Year)
ative Year)
Security
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Date Expira-
-------------------------------------- Exer- tion
cisable Date
Code V (A) (D)
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<S> <C> <C> <C> <C>
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7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Na-
lying Securities of of deriv- ship ture
(Instr. 3 and 4) Deriv- ative Form of In-
ative Securi- of De- direct
Secur- ties rivative Bene-
ity Bene- Secu- ficial
(Instr. ficially rity: Own-
5) Owned Direct ership
- ----------------------------------- at End (D) or (Instr. 4)
Amount or of Indi-
Title Number of Month rect (I)
Shares (Instr. 4) (Instr. 4)
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Explanation of Responses:
(1) Exchanged for 2,309,694 shares of common stock of (2) 1,540,663 shares disposed of by North Pacific Mining
Dakota Mining Corporation pursuant to a merger of Corporation, a subsidiary of CIRI, Inc.
USMX, Inc. into Dakota Merger Corporation. 1,000,000 shares disposed of by Peak Oilfield Service
Company, of which CIRI, Inc. is a general partner.
**Intentional misstatements or omissions of facts constitute By:
Federal Criminal Violations. SEE 18 U.S.C. 1001 -------------------------------- -----------
and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually
signed. If space is insufficient, SEE Instruction 6 for Its:
procedure. ------------------------------------------
On behalf of Cook Inlet Region, Inc. ***
Potential persons who are to respond to the collection of information
contained in this form are not required to respond unless the form ***In executing and filing this Form 4, Cook Inlet
displays a currently valid OMB Number. Region, Inc. does not intend to waive the exemption
afforded it under 43 U.S.C Section 1625. Page 2
SEC 1474 (7.96)
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