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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT 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 1474 (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 Following Reported Transaction(s) (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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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Options (right to buy) | $ 19.75 | 02/15/2006 | M | 9,750 | (2) | 04/09/2010 | Common Stock | 13,000 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MOUG KEVIN G 215 S CASCADE ST FERGUS FALLS, MN 56537-2801 |
CFO & Treasurer |
/s/ Kevin G Moug by Debra J Lill -POA | 02/16/2006 | |
**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) | See below for other holdings: 1. Direct holding of 792 shares that are held jointly with his wife in "street name" with US Bank. 2. Direct holding of 625.1275 shares held in the Employee Stock Purchase Plan. 3. Direct holding of 7,725 shares which is a grant of Restricted Stock. 4. Direct holding of 7,458 shares which no longer carries the restriction. 5. Indirect holding of 184.1466 shares held by ESOP. 6. Indirect holding of 11.2932 shares held by his children in custodian accounts. 7. 25,000 stock options with expiration date of 4/8/2011. |
(2) | The options become exercisable in four equal annual installments on the anniversaries of the date of grant, beginning April 10, 2001. |