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OMB APPROVAL
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OMB Number 3235-0362
Expires: April 30, 1997
Estimated average burden
hours per response ....... 1.0
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
ANNUAL 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).
[ ] Form 3 Holdings Reported
[x ] Form 4 Transactions Reported
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1. Name and Address of Reporting Person
Gentner Roland W.
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(Last) (First) (Middle)
5980 Wildwood Drive
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(Street)
Rapid City SD 57702
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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
December, 1998
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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 [ ] 10% Owner
[ x ] Officer (give title below) [ ] Other (specify below)
President / Chief Executive Officer
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
5. 6.
4. Amount of Owner-
Security Acquired (A) or Securities ship
Disposed of (D) Beneficially Form: 7.
(Instr. 3, 4 and 5) Owned at End Direct Nature of
2. 3. ----------------------------- of Issuer's (D) or Indirect
1. Transaction Transaction (A) Fiscal Year Indirect Beneficial
Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (Instr. 8) (D) & 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock $.001 par value 12/16/98 **J 30,000 A 2,255,600 D
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Common Stock $.001 par value 1,150 I Gregory
Gentner Trust
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Common Stock $.001 par value 1,150 I Eric
Gentner Trust
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Common Stock $.001 par value 1,150 I Drew
Gentner Trust
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
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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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<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
or Derivative 6. of Underlying 8. ities Secur- of
Exer- Securities Date Securities Price Bene- ity: In-
cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship
Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) 8) (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>
Stock Option 8.80 (1) 5/11/99 Common 21,688 21,688 D
(right to buy) Stock
$.001 par value
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Stock Option 6.4625 (2) 3/31/00 Common 34,000 34,000 D
(right to buy) Stock
$.001 par value
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</TABLE>
Explanation of Responses:
** Award of restricted stock pursuant to Sodak Gaming, Inc. 1993 Stock Option
Plan exempt under Rule 16b-3. 50% of shares become fully vested and
transferable as of 1/1/99 and the remaining 50% of shares become fully
vested and transferable on 1/1/00.
1. Grant to reporting person of option to buy 21,688 shares of common stock
under Sodak Gaming, Inc. 1993 Stock Option Plan in transaction exempt
under Rule 16b-3. The option becomes exerciseable in 25% increments on
5/11/95, 5/11/96, 5/11/97, and 5/11/98 respectively. This option was
previously reported as covering 10,844 shares, but was
adjusted to reflect a stock split on September 27, 1996.
2. Grant to reporting person of option to buy 34,000 shares of common stock
under Sodak Gaming, Inc. 1993 Stock Option Plan in transaction exempt
under Rule 16b-3. The option becomes exerciseable in 25% increments on
3/31/96, 3/31/97, 3/31/98, 3/31/99, and 3/31/00 respectively. This option
was previously reported as covering 17,000 shares, but was
adjusted to reflect a stock split on September 27, 1996.
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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 procedure.
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