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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 2270 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SARTINI BLAKE L 2411 WEST SAHARA AVENUE LAS VEGAS, NV 89102 |
 |  |  | Resigned Director |
Blake L. Sartini | 02/11/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The Blake L. Sartini and Delise F. Sartini Family Trust u/a/d 9/16/91, as amended and restated. |
(2) | The Blake L. Sartini 2004 QuickGRAT u/a/d 2/25/04, of which the reporting person is trustee. |
(3) | The Delise F. Sartini 2004 QuickGRAT u/a/d 2/25/04, of which the reporting person's spouse is trustee. |
(4) | Activity is for the Blake L. Sartini, II Trust u/a/d 10/1/93, and/or the Lorenzo M. Sartini Trust u/a/d 10/1/93, and/or the Sandra V. Sartini Trust u/a/d 10/1/93 (F/B/O the reporting person's minor children), of which the reporting person is Settlor. |
(5) | Gift. |
(6) | This amount represents an exchange of stock of 250,000 shares of Station Casinos, Inc. common stock between the reporting person and a GRAT of which the reporting person is the trustee. Each transfer of common stock of the issuer between the reporting person and the GRAT qualifies as only a change in form of the reporting person's beneficial ownership which does not change the number of shares beneficially owned by the reporting person or the GRAT, directly or indirectly. |
(7) | This amount represents an exchange of stock of 250,000 shares of Station Casinos, Inc. common stock between the reporting person's spouse and a GRAT of which the reporting person's spouse is the trustee. Each transfer of common stock of the issuer between the reporting person's spouse and the GRAT qualifies as only a change in form of the reporting person's spouse beneficial ownership which does not change the number of shares beneficially owned by the reporting person's spouse or the GRAT, directly or indirectly. |
(8) | This amount represents an exchange of stock of 93,762 shares of Station Casinos, Inc. common stock between the reporting person and a GRAT of which the reporting person is the trustee. Each transfer of common stock of the issuer between the reporting person and the GRAT qualifies as only a change in form of the reporting person's beneficial ownership which does not change the number of shares beneficially owned by the reporting person or the GRAT, directly or indirectly. |
(9) | This amount represents an exchange of stock of 93,762 shares of Station Casinos, Inc. common stock between the reporting person's spouse and a GRAT of which the reporting person's spouse is trustee. Each transfer of common stock of the issuer between the reporting person's spouse and the GRAT qualifies as only a change in form of the reporting person's spouse beneficial ownership which does not change the number of shares beneficially owned by the reporting person's spouse or the GRAT, directly or indirectly. |