-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GN/Ejofg1fBOxTCsfHPDt7jjkzWQi070EpNGsiAtLpZF+dJm5nM3Z828Q5pzp92C nwvbYa04i/jeUvaBpl0UBA== 0001193125-05-027228.txt : 20050214 0001193125-05-027228.hdr.sgml : 20050214 20050211174040 ACCESSION NUMBER: 0001193125-05-027228 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050214 DATE AS OF CHANGE: 20050211 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BEVERLY NATIONAL CORP CENTRAL INDEX KEY: 0000742275 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 042832201 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-58915 FILM NUMBER: 05600505 BUSINESS ADDRESS: STREET 1: 240 CABOT ST CITY: BEVERLY STATE: MA ZIP: 01915 BUSINESS PHONE: 9789222100 MAIL ADDRESS: STREET 1: 240 CABOT ST CITY: BEVERLY STATE: MA ZIP: 01915 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: BEVERLY NATIONAL CORP EMPLOYEE STOCK OPTION PLAN CENTRAL INDEX KEY: 0001279739 IRS NUMBER: 043206562 STATE OF INCORPORATION: MA FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: 240 CABOT STREET CITY: BEVERLY STATE: MA ZIP: 01915 SC 13G 1 dsc13g.htm SCHEDULE 13G Schedule 13G

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

SCHEDULE 13G

(Rule 13d-102)

 

 

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT

TO RULES 13d-1(b) (c), AND (d) AND AMENDMENTS THERETO FILED

PURSUANT TO RULE 13d-2(b)

(Amendment No.     )1

 

 

 

Beverly National Corporation


(Name of Issuer)

 

Common Stock


(Title of Class of Securities)

 

 

088115100


                                (CUSIP Number)                                

 

December 31, 2004


(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

¨ Rule 13d-1(b)

 

¨ Rule 13d-1(c)

 

x Rule 13d-1(d)

 

1   The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

 

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).


CUSIP No. 088115100

 

13G

 

  1.  

NAMES OF REPORTING PERSONS:

 

            BEVERLY NATIONAL CORPORATION EMPLOYEE

            STOCK OWNERSHIP PLAN

 

I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY)

 

            04-3206562

   
  2.  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*

(a)  

(b)  

 

            NOT APPLICABLE

   
  3.  

SEC USE ONLY

 

   
  4.  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

            MASSACHUSETTS, U.S.A.

   

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

 

  5.    SOLE VOTING POWER

 

                121,532


  6.    SHARED VOTING POWER

 


  7.    SOLE DISPOSITIVE POWER

 

                121,532


  8.    SHARED DISPOSITIVE POWER

 

  9.  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

            121,532

   
10.  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*

 

            NOT APPLICABLE

   
11.  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9

 

            6.53%

   
12.  

TYPE OF REPORTING PERSON

 

            EP

   

 

 

Page 2 of 4


Item 1

 

(a).

   Name of Issuer:          
         BEVERLY NATIONAL CORPORATION          

Item 1

 

(b).

   Address of Issuer’s Principal Executive Offices:          
         240 CABOT STREET, BEVERLY, MA 01915          

Item 2

 

(a).

   Name of Person Filing:          
        

PETER E. SIMONSEN, SENIOR VICE PRESIDENT & C.F.O.

PLAN ADMINISTRATOR FOR BEVERLY NATIONAL

CORPORATION EMPLOYEE STOCK OWNERSHIP PLAN

         

Item 2

 

(b).

   Address of Principle Business Office or, if None, Residence:          
         240 CABOT STREET, BEVERLY, MA 01915          

Item 2

 

(c).

   Citizenship:          
         MASSACHUSETTS, U.S.A.          

Item 2

 

(d).

   Title of Class of Securities:          
         COMMON STOCK          

Item 2

 

(e).

   CUSIP Number:              
         088115100          

Item 3.

  If This Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a:     
   

NOT APPLICABLE

         

 

Page 3 of 4


Item 4.

   Ownership.          
     Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1:          
     (a)    Amount beneficially owned: 121,532          
     (b)    Percent of class: 6.53%          
     (c)    Number of shares as to which such person has:          
          (i)    Sole power to vote or to direct the vote 121,532          
          (ii)    Shared power to vote or to direct the vote                       
          (iii)    Sole power to dispose or to direct the disposition of 121,532          
          (iv)    Shared power to dispose or to direct the disposition of                       

Item 5.

   Ownership of Five Percent or Less of a Class.     
     NOT APPLICABLE     

Item 6.

   Ownership of More than Five Percent on Behalf of Another Person.          
     NOT APPLICABLE     

Item 7.

   Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.
     NOT APPLICABLE     

Item 8.

   Identification and Classification of Members of the Group.          
     NOT APPLICABLE     

Item 9.

   Notice of Dissolution of Group.          
     NOT APPLICABLE     

Item 10.

   Certifications.          
     NOT APPLICABLE     

 

After reasonable inquiry and to the best of its knowledge and belief, each of the undersigned certifies that the information set forth in this statement is true, complete and correct.

 

2/14/2005


Date

/s/    Peter E. Simonsen


Signature
Name/Title
PETER E. SIMONSEN

SENIOR VICE PRESIDENT &

CHIEF FINANCIAL OFFICER

 

Page 4 of 4

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