15-12G 1 a04-12351_21512g.htm 15-12G

 

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C.  20549

 

FORM 15

 

CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER
SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION
OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934.

 

Commission File Number

000-19368

 

Community First Bankshares, Inc.

(Exact name of registrant as specified in its charter)

 

520 Main Avenue,

Fargo, North Dakota 58124-0001

(701) 298-5600

(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)

 

COMMON STOCK, $.01 PAR VALUE

PREFERRED STOCK PURCHASE RIGHTS

(Title of each class of securities covered by this Form)

 

None

(Titles of all other classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)

 

Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:

 

Rule 12g-4(a)(1)(i)

ý

 

Rule 12h-3(b)(1)(i)

ý

Rule 12g-4(a)(1)(ii)

o

 

Rule 12h-3(b)(1)(ii)

o

Rule 12g-4(a)(2)(i)

o

 

Rule 12h-3(b)(2)(i)

o

Rule 12g-4(a)(2)(ii)

o

 

Rule 12h-3(b)(2)(ii)

o

 

 

 

Rule 15d-6

o

 

Approximate number of holders of record as of the certification or notice date:

1

 

Pursuant to the requirements of the Securities Exchange Act of 1934 Community First Bankshares, Inc., has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.

 

Date:

November 1, 2004

 

 

COMMUNITY FIRST BANKSHARES, INC.

 

 

 

 

 

 

By:

/s/ Kevin F. Ames

 

 

 

Kevin F. Ames

 

 

 

Executive Vice President and Chief Financial Officer