-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, O1eK0vSoNhYwX9bqe5bAgRq1y86GZXUkcgIF2qyHdCY453yZ6n8EFIXYhsmtd6LF plOU7Qd3JbPixG86Uvn8pQ== 0000950137-09-000933.txt : 20090211 0000950137-09-000933.hdr.sgml : 20090211 20090211102729 ACCESSION NUMBER: 0000950137-09-000933 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20090211 DATE AS OF CHANGE: 20090211 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HAWTHORN BANCSHARES, INC. CENTRAL INDEX KEY: 0000893847 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 431626350 STATE OF INCORPORATION: MO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-49021 FILM NUMBER: 09587975 BUSINESS ADDRESS: STREET 1: 300 SOUTHWEST LONGVIEW BLVD. CITY: LEE'S SUMMIT STATE: MO ZIP: 64081 BUSINESS PHONE: (573)761-6100 MAIL ADDRESS: STREET 1: P.O. BOX 688 CITY: JEFFERSON CITY STATE: MO ZIP: 65102 FORMER COMPANY: FORMER CONFORMED NAME: EXCHANGE NATIONAL BANCSHARES INC DATE OF NAME CHANGE: 19940323 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: CAMPBELL DONALD L CENTRAL INDEX KEY: 0000939203 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 132 EAST HIGH STREET CITY: JEFFERSON CITY STATE: MO ZIP: 65101 BUSINESS PHONE: 5737616100 MAIL ADDRESS: STREET 1: 132 EAST HIGH ST CITY: JEFFERSON CITY STATE: MO ZIP: 65101 SC 13G/A 1 c49333bsc13gza.htm SC 13G/A sc13gza
     
SEC 1745
(02-02)
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No.      14     )*
HAWTHORN BANCSHARES, INC.
 
(Name of Issuer)
COMMON STOCK – $1.00 PAR VALUE
 
(Title of Class of Securities)
420476103
(CUSIP Number)
 
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
o   Rule 13d-l(b)
 
o   Rule 13d- l(c)
 
o   Rule 13d- l(d)
*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
 
 

 


 

                     
CUSIP No.
 
420 476103 
 

 

           
1   NAMES OF REPORTING PERSONS.
I.R.S. Identification Nos. of above persons (entities only).
       DONALD L. CAMPBELL                                                                 #500 24 0720
     
     
2   CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (SEE INSTRUCTIONS)

  (a)   NOT APPLICABLE
  (b)   NOT APPLICABLE
     
3   SEC USE ONLY
   
   
     
4   CITIZENSHIP OR PLACE OF ORGANIZATION
   
  UNITED STATES CITIZEN
       
  5   SOLE VOTING POWER
     
NUMBER OF   214,389
       
SHARES 6   SHARED VOTING POWER
BENEFICIALLY    
OWNED BY   0
       
EACH 7   SOLE DISPOSITIVE POWER
REPORTING    
PERSON   214,389
       
WITH 8   SHARED DISPOSITIVE POWER
     
    0
     
9   AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
  214,389
     
10   CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
   
  N/A
     
11   PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
   
  5.2%
     
12   TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
   
  IN


 

    Page 3 of 5 Pages
ITEM 1:
  (a)   Name of Issuer: Hawthorn Bancshares, Inc.
 
  (b)   Address of Issuer’s Principal Executive Offices:
132 East High Street
Jefferson City, Missouri  65101
ITEM 2:
  (a)   Name of Person Filing: This Schedule 13G is filed Pursuant to Rule 13d-1 © of the Securities and Exchange Act of 1934, as amended. It is filed by the following person: Donald L. Campbell (“Mr. Campbell”).
 
  (b)   Address of Principal Business Office or, if none, Residence: The business address for Mr. Campbell is 132 East High Street, Jefferson City, Missouri 65101.
 
  (c)   Citizenship: Mr. Campbell is a United States citizen
 
  (d)   Title of Class of Securities: Common stock, par value $1.00 per share.
 
  (e)   CUSIP No.: 420476103
ITEM 3:   If this statement is filed pursuant to Rules 13d-1 (b), or 13d-2 (b), check whether the person filing is a:
Not applicable.
ITEM 4:   Ownership (as of December 31, 2008)
Amount beneficially owned: Mr. Campbell may be deemed the beneficial owner of (i) 155,178 shares owned of record by Campbell Family L. P., which currently holds all shares previously owned of record by Mr. Campbell and his wife, and (ii) 56,211 shares held in the Donald L. Campbell Tr u/a Sept. 27, 1997 Donald L. Campbell Trust and (iii) 3,000 shares owned solely by Mr. Campbell. Mr. Campbell has sole voting and investment power over all the shares owned.

 


 

    Page 4 of 5 Pages
  (b)   Percent of class: The shares identified in paragraph (a) above as being beneficially owned by Mr. Campbell represent 5.2% of the 4,136,495 shares outstanding on December 31, 2008.
 
  (c)   Number of shares of which such person has:
  (I)   sole power to vote or to direct the vote:
 
      214,389 shares.
 
  (ii)   shared power to vote or to direct the vote: - 0 - shares.
 
  (iii)   sole power to dispose or to direct the disposition of: 214,389 shares.
 
  (iv)   shared power to dispose or to direct the disposition of: - 0 - shares.
ITEM 5:   Ownership of Five Percent or Less of a Class.

Not applicable.
ITEM 6:   Ownership of More than Five Percent on Behalf of Another Person.

Not applicable.
ITEM 7:   Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company.

Not applicable.
ITEM 8:   Identification and Classification of Members of the Group.

Not applicable.
ITEM 9:   Notice of Dissolution of Group.

Not applicable.

 


 

    Page 5 of 5 Pages
ITEM 10:   Certification.
Not applicable.
SIGNATURE
               After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Dated: February 10, 2009
             
 
  BY:   /s/ Donald L. Campbell
 
Donald L. Campbell
   

 

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