FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
UNITED FINANCIAL CORP \MN\ [ UBMT ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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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 at end of Issuer's Fiscal Year (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, no par value per share | 08/04/2004 | G | 125 | D | $0 | 43,987.27 | D | ||||||||
Common stock, no par value per share | 09/20/2004 | G | 50 | D | $0 | 43,937.27(1) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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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) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Employee Stock Options | $9.015 | 05/23/2001(2) | 05/23/2010 | common stock | 1,475 | 1,475 | D | |||||||
Employee Stock Options | $10.697 | 05/22/2002(3) | 05/22/2011 | common stock | 6,600 | 6,600 | D | |||||||
Employee Stock Options | $14.182 | 05/21/2003(4) | 05/21/2012 | common stock | 9,900 | 9,900 | D | |||||||
Employee Stock Options | $17.467 | 05/20/2004(5) | 05/20/2013 | common stock | 750 | 750 | D | |||||||
Employee Stock Options | $24.86 | 05/25/2005(6) | 05/25/2014 | common stock | 400 | 400 | D |
Explanation of Responses: |
1. Includes 26,392 shares held directly, 9,465 shares held in an IRA for the benefit of Mr. Feurt, and 8,080.27 shares held in a 401k account for the benefit of Mr. Feurt. The shares held in Mr. Feurt's 401k account reflect routine acquisitions due to reinvestments of dividends in the Heritage Bank Safe Harbor P/S plan as of 12/31/04. |
2. Grant date of 05/23/2000, exercisable as to 1443.75 shares on each of 05/23/01, 05/23/02, 05/23/03, 05/23/04. |
3. Grant date of 05/22/2001, exercisable as to 1650 shares on each of 05/22/02, 05/22/03, 05/22/04, 05/22/05. |
4. Grant date of 05/21/2002, exercisable as to 2475 shares on each of 05/21/03, 05/21/04, 05/21/05, 05/21/06. |
5. Grant date of 05/20/2003, exercisable as to 187.50 shares on each of 05/20/04, 05/20/05, 05/20/06, 05/20/07. |
6. Grant date of 05/25/2004, exercisable as to 100 shares on each of 05/25/05, 05/25/06, 05/25/07, 05/25/08. |
Kurt R Weise POA, On Behalf of Steve L Feurt | 02/11/2005 | |
** 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 Number. |