4 1 j9145_4.htm 4

FORM 4

/ / Check this box if no longer subject to Section 16.  Form 4 or Form 5 obligations may continue.
See Instruction 1(b).

(Print or Type Responses)

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, 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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 1. Name and Address of Reporting Person *



Anderson         Mark        A.

(Last)            (First)              (Middle)


520 Main Avenue

(Street)


Fargo        ND     58124

(City)       (State)          (Zip)

 

 2. Issuer Name and Ticker
    or Trading Symbol

Community First
Bankshares, Inc.
CFBX



 3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)

 

 

 4. Statement for
    Month/Day/Year

April 1, 2003





 5. If Amendment, Date of
    Original (Month/Day/Year)

 

 


 6. Relationship of Reporting Person(s) to Issuer

     (Check all applicable)

 /X /   Director

 

 /X /   Officer (give title below)

 

 /  /   10% Owner

 

 /  /   Other (specify below)
         President & CEO

 


 7. 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)

 

 

 

 

 

 

 

285,184

D

 

 

 

 

 

 

 

 

 

3,277

I

Uniform G to Minors

 

 

 

 

 

 

 

 

9,068

I

401 (k)

 

4/1/03

4/4/03

1

 

5,151

D

$ 25.3245

0 (a)

I

SERP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(a) Intra plan transfer of phantom stock units, not at the volition of the insider.


 

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 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 Securities: 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

14.00

 

 

 

 

 

 

(1)

2/8/10

Common Stock

60,000

 

40,000

D

 

Option

19.3125

 

 

 

 

 

 

(1)

2/6/11

Common Stock

50,000

 

41,666

D

 

Option

24.25

 

 

 

 

 

 

(1)

2/5/12

Common Stock

60,000

 

60,000

D

 

Option

26.25

 

 

 

 

 

 

(2)

2/2/09

Common Stock

16,361

 

16,361

D

 

Option

26.25

 

 

 

 

 

 

(3)

2/8/10

Common Stock

13,727

 

13,727

D

 

Option

26.25

 

 

 

 

 

 

(4)

2/6/11

Common Stock

6,853

 

6,853

D

 

Option

$27.23

 

 

 

 

 

 

(2)

2/2/09

Common Stock

15,979

 

15,979

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Option (Right to buy)

 

 Explanation of Responses:
(1) The option becomes exercisable with respect to one-third of the shares per year, commencing one year from the date of grant, which is also nine years prior to the expiration date.

(2) Option acquired via reload feature of $19.5625 option grant.

(3) Option acquired via reload feature of $14.00 option grant.

(4) Option acquired via reload feature of $19.3125 option grant.

 

 

 

/s/ Galen O. Skarphol ***

** Signature of Reporting Person

April 1, 2003

Date

 

 

 

 

***Attorney-in-fact, pursuant to Power-of-Attorney dated September 5, 2002.

 

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).

 

Note:   File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

 

 

http://www.sec.gov/divisions/corpfin/forms/form4.htm

Last update: 09/05/2002