UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
( ) Check box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See Instructions 1(b).
(X) Form 3 Holdings Reported
( ) Form 4 Transactions Reported
1. Name and Address of Reporting Person
LARSEN, JOHN L.
877 NORTH 8TH WEST
RIVERTON, WY 82501
USA
2. Issuer Name and Ticker or Trading Symbol
NORTHWEST GOLD, INC.
NWG
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
APRIL 2000
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
(X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other
(specify below)
7. Individual or Joint/Group Reporting (Check Applicable Line)
(X) Form filed by One Reporting Person
( ) Form filed by More than One Reporting Person
<TABLE>
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Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect |
|Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership |
|Date |Code| | Beneficially |(D)or | |
| | | | A/| | Owned at |Indir | |
| | | Amount | D | Price | End of Year |ect(I)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
$.001 Par Value Common St|04/03/|3(a)|100,000 | |N/A |100,000 |D | |
ock |00 | | | | | | | |
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$.001 Par Value Common St|04/03/|3(a)|100,000 | |N/A |100,000 |I (b) |By Wife |
ock |00 | | | | | | | |
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$.001 par Value Common St|04/03/|3(a)|25,242,500 | |N/A |25,242,500 |I (c) |By USE |
ock |00 | | | | | | | |
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Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned |
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1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of|
Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect |
|or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial |
|cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership |
|ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | |
|Deriva | | | |Date |Expir| | |ficially |Ind| |
|tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| |
|Secu | | | | D |cisa-|Date | of Shares | |End of |ct | |
|rity | | | Amount | |ble | | | |Year |(I)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Explanation of Responses:
(a) The Reporting Person became a director of the Issuer on April 3,
2000.
(b) Consists of shares held directly by the Reporting Person's
wife.
(c) Consists of shares held by U.S. Energy Corp. ("USE"). The Reporting
Person is an officer and director of USE
and director of NWG. The Reporting Person is not a controlling shareholder of
USE, and therefore the Reporting
Person does not have a pecuniary interest in the NWG shares held by USE, under
Rule 16a-1(a)(2)(iii).
The Reporting Person disclaims beneficial and pecuniary interest in the shares
reported under footnotes b and c.
SIGNATURE OF REPORTING PERSON
/s/ JOHN L. LARSEN
DATE
JULY 14, 2000