This pattern consists of the Washington Obverse with the motto "God and Our Country" combined with the Short 5 reverse.
Examples are known as follows:
Nickel J483/P573 which is believed to be unique and has not been seen since its last offering as lot 248 in Elder's 1908 Gschwend sale.
Copper and/or Bronze J484-J485/P574 with at least 4 known as follows.
1) Mitchelson-Connecticut State Library
2) Lohr (listed as J585 in error) in the Empire Coin FPL), Polis-B/M 6/91, Superior 3/2000 as NGC66BN, Teletrade 7/5/2000, Heritage 6/05 - PCGS66BN, illustrated above, click on the thumbnail image to enlarge.
3) Kagin's 7/75, B/M 1/97 - PCGS65RB
4) Crouch-Superior 6/77, Ivy 8/80 ANA?
Photo courtesy of Superior.