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OMB APPROVAL
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OMB Number 3235-0287
Expires: April 30, 1997
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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
[ ] Check this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person
Buntrock Kevin
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(Last) (First) (Middle)
5301 S. Highway 16
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(Street)
Rapid City South Dakota 57701
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Sodak Gaming, Inc. (SODK)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
January 1997
5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[ X ] Officer (give title below) [ ] Other (specify below)
Vice President Corporate Development
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock $.001 par value *632 D
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
*After giving effect to the September 27, 1996 2 for 1 stock split.
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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)
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<TABLE>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Stock Option 8.00 (1) 5/11/04 Common *2,012 *2,012 D
Stock
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Stock Option 5.875 (2) 3/31/05 Common *18,000 *18,000 D
Stock
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Stock Option 12.6875 (3) 2/26/06 Common *40,000 *40,000 D
Stock
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Stock Option 16.375 1/30/97 A V 40,000 (4) 1/30/07 Common 40,000 40,000 D
Stock
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</TABLE>
Explanation of Responses:
1. Grant to reporting person of option to buy shares of Common Stock under
the Sodak Gaming 1993 Stock Option Plan in transaction exempt under Rule
16b-1.The Option becomes exerciseable in 25% increments on 5/11/95,
5/11/97, 5/11/98, respectively.
2. Grant to reporting person of option to buy shares of Common Stock under
the Sodak Gaming 1993 Stock Option Plan in transaction exempt under Rule
16b-1. The Option becomes exerciseable in 25% increments on 3/31/96,
3/31/97, 3/31/98, 3/31/99 respectively.
3. Grant to reporting person of option to buy shares of Common Stock under
the Sodak Gaming 1993 Stock Option Plan in transaction exempt under Rule
16b-1.The Option becomes exerciseable in 25% increments on 2/26/97,
2/26/98, 2/26/99 and 2/26/00 respectively.
4. Grant to reporting person of option to buy shares of Common Stock under
the Sodak Gaming 1993 Stock Option Plan in transaction exempt under Rule
16b-1.The Option becomes exerciseable in 25% increments on 1/30/98,
1/30/99, 1/30/00, and 1/30/01 respectively.
*After giving effect to the September 27, 1996 2 for 1 stock split.
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**Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedures.
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