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FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL
------ WASHINGTON, D.C. 20549 -------------------------------
OMB Number 3235-0362
|_| Check this box if ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Expires: September 30, 1998
no longer subject Estimated average burden
to Section 16. Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, hours per response........1.0
Form 4 or Form 5 Section 17(a) of the Public Utility Holding Company Act of 1935 -------------------------------
obligations may or Section 30(f) of the Investment Company Act of 1940
continue. See
Instruction 1(b)
|_| Form 3 Holdings Reported
|_| Form 4 Transactions Reported
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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)
FUERST KIM M. COLORADO WYOMING RESERVE COMPANY (CWYR) X Director X 10% Owner
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(Last) (First) (Middle) 3.IRS or Social Security 4.Statement for X Officer (give Other (Specify
Number of Reporting Month/Year --- title --- below)
Person (Voluntary) below)
FISCAL YEAR
751 HORIZON COURT, SUITE 205 ENDED 06/30/00 PRESIDENT & CHIEF EXECUTIVE OFFICER
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(Street) 5.If Amendment, 7.Individual or Joint/Group Filing
Date of Original (Check applicable line)
(Month/Year) X Form filed by One Reporting Person
GRAND JUNCTION CO 81506 ---
------------------------------------------ Form filed by More than One
(City) (State) (Zip) --- Reporting Person
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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.Transaction 4.Securities Acquired (A) 5.Amount of 6.Ownership 7.Nature of
(Instr. 3) action Code or Disposed of (D) Securities Form: Indirect
Date (Instr. 8) (Instr. 3, 4 and 5) Beneficially Direct (D) or Beneficial
------------------------------- Owned at End Indirect (I) Ownership
(Month/ of Issuer's (Instr. 4) (Instr. 4)
Day/ Amount (A) or Price Fiscal Year
Year) (D) (Instr. 3 and 4)
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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 2270 (7-96)
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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)
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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 Expiration Securities Deriv-
Price of (Month/ (Instr. 8) Acquired (A) Date (Instr. 3 and 4) ative
Deriv- Day/ or (Month/Day/ Secur-
ative Year) Disposed of (D) Year) ity
Security (Instr. 3, 4, (Instr. 5)
and 5)
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Date Expira- Amount or
(A) (D) Exer- tion Title Number of
cisable Date Shares
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STOCK OPTION (RIGHT $0.75 07/26/99 A 500,000 07/26/99 07/26/04 COMMON 500,000
TO BUY) STOCK
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1. Title of Derivative 9. Number of 10. Ownership 11. Nature of
Security Derivative Form of Indirect
(Instr. 3) Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at End Direct (D) or (Instr. 4)
of Year Indirect (I)
(Instr. 4) (Instr. 4)
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500,000 D
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Explanation of Responses:
Intentional misstatements or omissions of facts /s/ Kim M. Fuerst October 12, 2000
constitute Federal Criminal Violations. ----------------------------- ----------------
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Kim M. Fuerst Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided 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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