SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SEYMANN MARILYN

(Last) (First) (Middle)
MONE, INC.
2813 EAST CAMELBACK ROAD, SUITE 480

(Street)
PHOENIX AZ 85016

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
COMMUNITY FIRST BANKSHARES INC [ CFBX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
11/01/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock (CFBX) 11/01/2004 D 1,000 D $32.25(1) 0 D
Common Stock (CFBX) 11/01/2004 D 4,249 D $32.25(1) 0 I Deferred Compensation Plan
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option - Right to Buy $20.375 11/01/2004 D 4,000(2) 04/27/1999 04/27/2009 Common Stock 4,000 $20.375 0 D
Option - Right to Buy $15.875 11/01/2004 D 4,000(2) 04/25/2000 04/25/2010 Common Stock 4,000 $15.875 0 D
Option - Right to Buy $21.49 11/01/2004 D 4,000(2) 04/24/2001 04/24/2011 Common Stock 4,000 $21.49 0 D
Option - Right to Buy $26.55 11/01/2004 D 4,000(2) 04/23/2002 04/23/2012 Common Stock 4,000 $26.55 0 D
Option - Right to Buy $26.29 11/01/2004 D 4,000(2) 04/22/2003 04/22/2013 Common Stock 4,000 $26.29 0 D
Explanation of Responses:
1. Disposal pursuant to Agreement and Plan of Merger dated as of March 15, 2004 between Community First Bankshares and BancWest Corporation which provides for a cash payment of $32.25 per common share.
2. Disposal pursuant to Agreement and Plan of Merger dated as of March 15, 2004 between Community First Bankshares and BancWest Corporation in which each option has been cancelled in exchange for a cash payment of $32.25 per share, less the exercise price per share, for each share subject to option grant.
Galen O. Skarphol, Attorney-in-fact 11/01/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
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