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HMNF HMN Financial Inc

26.40
-0.05 (-0.19%)
26 Jul 2024 - Closed
Delayed by 15 minutes
Share Name Share Symbol Market Type
HMN Financial Inc NASDAQ:HMNF NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  -0.05 -0.19% 26.40 10.57 42.25 26.60 26.01 26.48 1,158 23:41:14

Annual Statement of Changes in Beneficial Ownership (5)

14/02/2013 7:35pm

Edgar (US Regulatory)


FORM 5
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES

                                                                                  

OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response...
1.0
                      
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

JORGENSEN DWAIN C

2. Issuer Name and Ticker or Trading Symbol

HMN FINANCIAL INC [HMNF]

5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                      _____ 10% Owner
__ X __ Officer (give title below)      _____ Other (specify below)
SENIOR VICE PRESIDENT

(Last)          (First)          (Middle)

1016 CIVIC CENTER DR NW

3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2012 
(Street)

ROCHESTER, MN 55901

(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
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. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. 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)
Amount (A) or (D) Price
Common Stock                 50156   (1) D    
Common Stock                 2150   I   Spouse Marcia Jorgensen  
Common Stock                 18524   (2) I   ESOP Allocation  
Common Stock                 10048   (3) I   401(k)  

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. 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
(MM/DD/YYYY)
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 at End of Issuer's Fiscal Year
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option to Buy   $27.66                 3/3/2005   3/3/2014   Common Stock   1194     1194   D    
Option to Buy   $27.66                 3/3/2006   3/3/2014   Common Stock   1193     2387   D    
Option to Buy   $27.66                 3/3/2007   3/3/2014   Common Stock   1193     3580   D    

Explanation of Responses:
( 1)  Total number of shares has been increased by 1775 shares due to prior inadvertant under-reporting of the total number of shares directly held by the reporting person. Dividend reinvestment shares are also included in the total. Transactions were correctly reported and only the total holdings were misstated.
( 2)  Number of shares for ESOP holding includes allocation for the year ended Dec 31, 2012.
( 3)  Number of shares shown for 401(k) holdings reflects transactions within the plan during 2012.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
JORGENSEN DWAIN C
1016 CIVIC CENTER DR NW
ROCHESTER, MN 55901


SENIOR VICE PRESIDENT

Signatures
Jon Eberle for Dwain Jorgensen by Power of Attorney /s/ Jon Eberle 2/14/2013
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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.

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