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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4 OMB APPROVAL
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[_] Check this box if no longer OMB NUMBER: 3235-0287
subject to Section 16. Form 4 Expires: September 30, 1998
or Form 5 obligations may Estimated average burden
continue. See Instruction 1(b). hours per response ...... 0.5
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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
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Malone, Jr. Arthur L.
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(Last) (First) (Middle)
P. O. Box 386 / 638 Lindero Canyon Road
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(Street)
Agoura Hills CA 91301
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Creative Gaming, Inc. CLPID
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
November 1997
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5. If Amendment, Date of Original (Month/Year)
- -
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
X Director X 10% Owner
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Officer (give Other (Specify
----- title below) ------ below)
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7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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Form filed by More than One Reporting Person
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<TABLE>
<CAPTION>
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature
(Instr. 3) action action or Disposed of (D) Securities Form: of Indirect
Date Code Beneficially Direct Beneficial
(Instr. 8) (Instr. 3,4 and 5) Owned at (D) or Ownership
(Month/ ------------ -------------------------- End of Month Indirect (Instr. 4)
Day/ Code V Amount (A) or Price (Instr. 3 (I)
Year) (D) and 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
12% Convertible Redeemable 11/15/97 S 646 D $26,000 66,554 D N/A
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Preferred Stock, Series C
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one person, see Instruction 4(b)(v).
(Print or Type Responses)
(Over)
SEC 1473 (8-92)
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FORM 4 (continued)
<TABLE>
<CAPTION>
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security 2. Conversion 3. Transaction 4. Transacation 5. Number of Derivative 6. Date Exercisable
(Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration
Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date
Derivative Year) (Instr. 3, 4, and 5) (Month/Day/
Security Year)
--------------- -------------------------- -------------------
Code V (A) (D) Date Expiration
Exer- Date
cisable
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Warrant to purchase common $ .10 9/97 9/99
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stock
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</TABLE>
<TABLE>
<CAPTION>
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect
Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership
(Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4)
Instr. 4) Indirect (I) (Instr. 4)
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Title Amount or
Number of
Shares
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<S> <C> <C> <C> <C> <C>
Common 875,000 875,000 D N/A
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</TABLE>
Explanation of Responses: The sale price of $26,000 was paid in cash and
stock in an unrelated company.
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Arthur L. Malone, Jr. December 9, 1997
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**Signature of Reporting Person Date
Arthur L. Malone, Jr.
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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SEC 1474 (8-92)
