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FORM 5 OMB APPROVAL
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OMB Number: 3235-0362
Expires: September 30, 1998
Estimated average burden
hours per response...... 1.0
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/ / 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
/X/ 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
Johnston Judy Morton Pan International Gaming, Inc. (Formerly Issuer (Check all applicable)
Johnston Clifford M Pan Environmental Corp) "PANE" 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
1911 3rd Ave NW Number of Reporting Month/Year ---- title --- below)
- ------------------------------------------- Person (Voluntary) 1998 below)
(Street) -------------------
Shoreline, WA 98177 N/A 5. If Amendment, -------------------------------
- ------------------------------------------- Date of Original
(City) (State) (Zip) (Month/Year) 7. Individual or Joint/Group Filing
N/A (Check applicable line)
------------------ Form Filed by one
---- Reporting Person
X 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. 8) End of Issuer's Direct Benefi-
(Month/ 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 12/1/1995 No Activity 22,000 I (1)
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Common Stock 1/15/1998 J(A) 76,666 D 0 3,334 I (1)
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Common Stock various 1998 J(B) 24,1999 D $11,250.00 6,319 I (1)
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Common Stock 1/15/1998 * 50,000 D 0 0 D
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Common Stock 1/15/1998 * 30,000 A&D 0 0 D
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Common Stock 6/23/1998 J(C) 69,000 $0.50/$34,500 61,000 I (1)
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Common Stock 1/19/1998 J(D) 100,000 D 0 0 I (1)
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Common Stock 10/1/1998 J** 100,000 A $100,000 100,000 D
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Common Stock 5/22/1998 JL 625,000 A&D 0 545,000 I (1)
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Common Stock 10/1/1998 J*** 146,000 A $146,000 146,000 I (1)
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Common Stock 10/1/1998 G,J**** 68,000 A&D 68,000 63,000 I (1)
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Common Stock 9/2/1998 P 7,000 A $7,316 7,000 I (1)
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* 80,000 Shares were resissued to Robert Bickel and Ronald Williams for settling out judgments against PAN in the amounts of
$122,709 and $121,809 respectively.
** S-8 Registered Offering in lien of wages
*** S-8 Registered Offering in lien of consulting fees
**** S-8 Registered Offering in lien of wife's wages and accounting fees.
*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) (8/96)
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<CAPTION>
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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<C> <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 (I) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
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Explanation of Responses: (1) Mr. Johnston is a managing member and 50% owner of Jekis, LLC dba
Bristol Media Ltd. and Valhalla Financial Group LLC. Mr. & Mrs. Johnston are managing members and sole
officers of 4 Point Lake, LLC, Quality Tax Service, Inc. and J & J Family Business Trust, all of which
are owned 100% by Mr. & Mrs. Johnston.
/s/ Clifford M. Johnston 4/28/99
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ [Signature Illegible] 4/28/99
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 provided is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this form are required to Page 2
respond unless the form displays a currently valid OMB number. SEC 2270 (9-97)
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<PAGE> 3
3(J)(A)
VALHALLA FINANCIAL GROUP, L.L.C.
ANALYSIS OF CERTIFICATE # 2664
FOR 80,000 SHARES DISPOSED OF
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<CAPTION>
Price
Per Total
Date Description Shares Share Price
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<S> <C> <C> <C> <C>
01/15/98 Stan Keeter - Gift 25,000 -0- -0-
01/15/98 Stan Keeter - Gift 15,000 -0- -0-
01/15/98 Casey Jones Corp. - Gift 4,650 -0- -0-
01/15/98 Donald W. Jones - Gift 3,683 -0- -0-
01/15/98 Steve McCowan - Gift 8,000 -0- -0-
01/15/98 Tom Fitzhugh - Gift 5,333 -0- -0-
01/15/98 Kamiko Anderson - Gift 12,500 -0- -0-
01/15/98 Tom Beardsley - Gift 2,500 -0- -0-
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Subtotal 76,666 -0-
Stock retained 12/31/98 3,334
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Total 80,000
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3(J)(B)
VALHALLA FINANCIAL GROUP, L.L.C.
ANALYSIS OF CERTIFICATE #2669
FOR 31,318 SHARES DISPOSED OF
<TABLE>
<CAPTION>
Price
Per Total
Date Description Shares Share Price
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<S> <C> <C> <C> <C>
02/05/98 Jones Law Group ) Given on 6,000 $.50 $ 3,000.00
Stephen Tollefsen ) behalf of 4,000 .50 2,000.00
Catherine E. Dixon) PAN 12,500 .50 6,250.00
02/25/98 Edward R. Jones - Gift 499 -0- -0-
07/03/98 Edward R. Jones - Gift 2,000 -0- -0-
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Subtotal 24,999 $11,250.00
Shares retained 12/31/98 6,319
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Total 31,318
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3(J)(C)
TCKTS, L.L.C. DBA BRISTOL MEDIA, LTD.
ANALYSIS OF CERTIFICATE #2674
FOR 130,000 SHARES DISPOSED OF
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<CAPTION>
Price
Per Total
Date Description Shares Share Price
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<S> <C> <C> <C> <C>
06/23/98 Bonnie Myers - Private Sale 40,000 $.50 $20,000.00
Lois L. Gardiner - Private Sale 4,000 .50 2,000.00
John Hatfield - Private Sale 4,000 .50 2,000.00
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Subtotal 69,000 $34,500.00
Shares retained 12/31/98 61,000
Total 130,000
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3(J)(D)
TCKTS, L.L.C. DBA BRISTOL MEDIA, LTD.
ANALYSIS OF CERTIFICATE #2671
FOR 100,000 SHARES DISPOSED OF
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<CAPTION>
Price
Per Total
Date Description Shares Share Price
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<S> <C> <C> <C> <C>
01/19/98 Gene Ekblad - Finders Fee 50,000 -0- -0-
Gene Ekblad - Finders Fee 1,000 -0- -0-
Casey Jones Corp. - Bonus 9,300 -0- -0-
Donald W. Jones - Bonus 7,366 -0- -0-
Tom Fitzhugh - Finders Fee 26,666 -0- -0-
Ed Jones - Gift 5,668 -0- -0-
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Total 100,000 -0-
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3(J)(E)
TCKTS, L.L.C. DBA BRISTOL MEDIA, LTD.
ANALYSIS OF CERTIFICATE #2753
FOR 625,000 SHARES DISPOSED OF
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<CAPTION>
Price
Per Total
Date Description Shares Share Price
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<S> <C> <C> <C> <C>
05/22/98 Randy Fitzhugh - Consulting
service incident to acquisition
of Whitfield 80,000 -0- -0-
-------- ---
Subtotal 80,000 -0-
Stock retained as of 12/31/98 545,000
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Subtotal 625,000
Stock Issued Directly
Whitfield Group, Ltd. ) Consulting services 10,000
J. Paul Christensen ) incident to acquisition 10,000
Kistler Mortgage Corp. ) of Whitfield 155,000
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Subtotal 175,000
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Total 800,000
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