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Previous: QUAKER CAPITAL MANAGEMENT CORP, 13F-HR, 2000-02-14 |
Next: CENTURY CASINOS INC, SC 13G/A, 2000-02-14 |
<PAGE> 1
-------------------------------
OMB APPROVAL
-------------------------------
OMB Number 3235-0362
Expire: December 31, 2001
Estimated average burden
hours per response ........1.0
-------------------------------
- ------
FORM 5
- ------
/ / 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,
/ / 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
<TABLE>
<S> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Issuer (Check all applicable)
Miller, III Lloyd I Century Casinos, Inc. (CTNY)
- --------------------------------------------------------------------------------------------- Director X 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (Specify
4550 Gordon Drive Person (Voluntary) December, 1999/ ---- title --- below)
- ------------------------------------------- January, 2000 below)
(Street) ###-##-#### -------------------
Naples FL 34102 5. If Amendment, 7. Individual of Joint/Group Filing
- ------------------------------------------- Date of Original (Check Applicable Line)
(City) (State) (ZIP) (Month/Year)
/X/ Form Filed by One Reoproting Person
------------------- / / Form Filed by more than 1 Reporting
Person
- ------------------------------------------------------------------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
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)
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/2/99 P4 16,000 A 1.01 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/15/99 P4 22,000 A .9375 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/22/99 P4 12,000 A .9475 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/22/99 P4 12,000 A .9375 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/28/99 P4 10,000 A .9375 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 12/30/99 P4 20,000 A .9375 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). (Over)SEC 2270 (7-96)
</TABLE>
Page 1 of 5
<PAGE> 2
<TABLE>
<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>
- ------------------------------------------------------------------------------------------------------------------------------------
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)
-----------------------------------
Date Expira- Amount or
--------------- Exer- tion Title Number of
(A) (D) cisable Date Shares
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- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
<S> <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)
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------
Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Lloyd I. Miller, III 2/12/2000
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. Page 2
If space provided is insufficient, see Instruction 6 for procedure. (Bulletin No. 177, 10-15-97)
</TABLE>
Page 2 of 5
<PAGE> 3
<TABLE>
<S> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Issuer (Check all applicable)
Miller, III Lloyd I Century Casinos, Inc. (CTNY)
- --------------------------------------------------------------------------------------------- Director X 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (Specify
4550 Gordon Drive Person (Voluntary) December, 1999/ ---- title --- below)
- ------------------------------------------- January, 2000 below)
(Street) ###-##-#### -------------------
Naples FL 34102 5. If Amendment, 7. Individual of Joint/Group Filing
- ------------------------------------------- Date of Original (Check Applicable Line)
(City) (State) (ZIP) (Month/Year)
/X/ Form Filed by One Reoproting Person
------------------- / / Form Filed by more than 1 Reporting
Person
- ------------------------------------------------------------------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
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)
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1/14/00 P4 27,350 A .9688 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1/14/00 P4 27,350 A .9688 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1/31/00 P4 18,550 A .9688 935,199 I By Lloyd
I. Miller
Trust A-4
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1/11/00 P4 12,000 A .9688 12,000 I By Lloyd
I. Miller
Trust A-2
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1/24/00 P4 6,000 A .9688 270,000 D
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 14,500 I By Lloyd
I. Miller
Trustee
GST f/b/o
Lloyd I.
Miller,
III
- ------------------------------------------------------------------------------------------------------------------------------------
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). (Over)
SEC 2270 (7-96)
</TABLE>
Page 3 of 5
<PAGE> 4
<TABLE>
<S> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Issuer (Check all applicable)
Miller, III Lloyd I Century Casinos, Inc. (CTNY)
- --------------------------------------------------------------------------------------------- Director X 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (Specify
4550 Gordon Drive Person (Voluntary) December, 1999/ ---- title --- below)
- ------------------------------------------- January, 2000 below)
(Street) ###-##-#### -------------------
Naples FL 34102 5. If Amendment, 7. Individual of Joint/Group Filing
- ------------------------------------------- Date of Original (Check Applicable Line)
(City) (State) (ZIP) (Month/Year)
/X/ Form Filed by One Reoproting Person
------------------- / / Form Filed by more than 1 Reporting
Person
- ------------------------------------------------------------------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
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)
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 17,300 I By Lloyd
I. Miller
III,
Trustee
GST
custodian
under
Florida
UGMA for
Lloyd I.
Miller,
IV
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 543,445 I By Milfam
I, L.P.
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 223,671 I By Milfam
II, L.P.
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 133,300 I By Lloyd
I. Miller
III
Trust C
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 10,000 I By Lloyd
I. Miller
III
Trustee,
GST f/b/o
Catherine
C. Miller
- ------------------------------------------------------------------------------------------------------------------------------------
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). (Over)
SEC 2270 (7-96)
</TABLE>
Page 4 of 5
<PAGE> 5
<TABLE>
<S> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Issuer (Check all applicable)
Miller, III Lloyd I Century Casinos, Inc. (CTNY)
- --------------------------------------------------------------------------------------------- Director X 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (Specify
4550 Gordon Drive Person (Voluntary) December, 1999/ ---- title --- below)
- ------------------------------------------- January, 2000 below)
(Street) ###-##-#### -------------------
Naples FL 34102 5. If Amendment, 7. Individual of Joint/Group Filing
- ------------------------------------------- Date of Original (Check Applicable Line)
(City) (State) (ZIP) (Month/Year)
/X/ Form Filed by One Reoproting Person
------------------- / / Form Filed by more than 1 Reporting
Person
- ------------------------------------------------------------------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
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)
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 4,000 I By Wife
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 29,800 I By Lloyd
I. Miller
III,
custodian
under
Florida
UGMA for
Alexandra
B. Miller
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 5,000 I By Lloyd
I. Miller
Trust A-1
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 6,000 I By Lloyd
I. Miller
Trust A-3
- ------------------------------------------------------------------------------------------------------------------------------------
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). (Over)
SEC 2270 (7-96)
</TABLE>
Page 5 of 5
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