-----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, NM2UHrhvc2KZND+X9ThHwhC/pUj/GTsTPxgi14v4yUOIWXyfABOuSPewcV3u7ba2 dTd1KVEX5FeURG2t0D/qGw== 0000950134-06-001294.txt : 20060127 0000950134-06-001294.hdr.sgml : 20060127 20060127085836 ACCESSION NUMBER: 0000950134-06-001294 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20060127 DATE AS OF CHANGE: 20060127 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: DAHLBERG K JEFFREY CENTRAL INDEX KEY: 0000938452 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 4200 DAHLBERG DRIVE CITY: MINNEAPOLIS STATE: MN ZIP: 55422 MAIL ADDRESS: STREET 1: GROW BIZ INTERNATIONAL INC STREET 2: 4200 DAHLBERG DRIVE CITY: MINNEAPOLIS STATE: MN ZIP: 55422-4837 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: WINMARK CORP CENTRAL INDEX KEY: 0000908315 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-MISCELLANEOUS RETAIL [5900] IRS NUMBER: 411622691 STATE OF INCORPORATION: MN FISCAL YEAR END: 1226 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-46803 FILM NUMBER: 06555281 BUSINESS ADDRESS: STREET 1: 4200 DAHLBERG DRIVE CITY: GOLDEN VALLEY STATE: MN ZIP: 55422-4837 BUSINESS PHONE: 6125208500 FORMER COMPANY: FORMER CONFORMED NAME: GROW BIZ INTERNATIONAL INC DATE OF NAME CHANGE: 19930629 SC 13G/A 1 c01917sc13gza.txt AMENDMENT TO SCHEDULE 13G OMB APPROVAL -------------------------- OMB Number: 3235-0145 Expires: December 31, 2005 Estimated average burden hours per response......11 SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 SCHEDULE 13G/A (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b)(c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(b) (Amendment No. 2)* Winmark Corporation - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, no par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 032681 10 8 - -------------------------------------------------------------------------------- (CUSIP Number) December 31, 2005 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [_] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(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 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. 032681 10 8 13G Page 2 of 5 Pages - -------------------------------------------------------------------------------- 1. NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) K. Jeffrey Dahlberg - -------------------------------------------------------------------------------- 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] (b) [_] - -------------------------------------------------------------------------------- 3. SEC USE ONLY - -------------------------------------------------------------------------------- 4. CITIZENSHIP OR PLACE OF ORGANIZATION USA - -------------------------------------------------------------------------------- NUMBER OF 5. SOLE VOTING POWER SHARES 502,146 ----------------------------------------------------------------- BENEFICIALLY 6. SHARED VOTING POWER OWNED BY 0 ----------------------------------------------------------------- EACH 7. SOLE DISPOSITIVE POWER REPORTING 502,146 ----------------------------------------------------------------- PERSON 8. SHARED DISPOSITIVE POWER WITH 0 - -------------------------------------------------------------------------------- 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 502,146 - -------------------------------------------------------------------------------- 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* See Exhibit A [X] - -------------------------------------------------------------------------------- 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 8.4% - -------------------------------------------------------------------------------- 12. TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- CUSIP No. 032681 10 8 13G Page 3 of 5 Pages - -------------------------------------------------------------------------------- Item 1(a). Name of Issuer: Winmark Corporation - -------------------------------------------------------------------------------- Item 1(b). Address of Issuer's Principal Executive Offices: 4200 Dahlberg Drive, Minneapolis, MN 55422 - -------------------------------------------------------------------------------- Item 2(a). Name of Person Filing: K. Jeffrey Dahlberg - -------------------------------------------------------------------------------- Item 2(b). Address of Principal Business Office, or if None, Residence: 1040 High Lake View, Colorado Springs, CO 80906 - -------------------------------------------------------------------------------- Item 2(c). Citizenship: USA - -------------------------------------------------------------------------------- Item 2(d). Title of Class of Securities: Common Stock, no par value - -------------------------------------------------------------------------------- Item 2(e). CUSIP Number: 032681 10 8 - -------------------------------------------------------------------------------- Item 3. If This Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a: (a) [_] Broker or dealer registered under Section 15 of the Exchange Act. (b) [_] Bank as defined in Section 3(a)(6) of the Exchange Act. (c) [_] Insurance company as defined in Section 3(a)(19) of the Exchange Act. (d) [_] Investment company registered under Section 8 of the Investment Company Act. (e) [_] An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E); (f) [_] An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F); (g) [_] A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G); (h) [_] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act; (i) [_] A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act; (j) [_] Group, in accordance with Rule 13d-1(b)(1)(ii)(J). CUSIP No. 032681 10 8 13G Page 4 of 5 Pages Item 4. Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 502,146 ---------------------------------------------------------------------- (b) Percent of class: 8.4% ---------------------------------------------------------------------- (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: 502,146 --------------------- (ii) Shared power to vote or to direct the vote: 0 -------------------- (iii) Sole power to dispose or to direct the disposition of: 502,146 ---------- (iv) Shared power to dispose or to direct the disposition of: 0 -------- - -------------------------------------------------------------------------------- Item 5. Ownership of Five Percent or Less of a Class. N/A - -------------------------------------------------------------------------------- Item 6. Ownership of More Than Five Percent on Behalf of Another Person. N/A - -------------------------------------------------------------------------------- Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person. N/A - -------------------------------------------------------------------------------- Item 8. Identification and Classification of Members of the Group. N/A - -------------------------------------------------------------------------------- Item 9. Notice of Dissolution of Group. N/A - -------------------------------------------------------------------------------- Item 10. Certifications. (a) Not applicable (b) 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: January 26, 2006 /s/ K. Jeffrey Dahlberg ------------------------------------ K. JEFFREY DAHLBERG EXHIBIT A This information is provided for informational purposes only. These securities are not included on page 2, item 11. Entity Number of shares ------ ---------------- Trust for the benefit of Reporting 225,000 Person's children. The Reporting Person's spouse is the sole trustee. The reporting person is not a trustee of such trust and disclaims beneficial ownership of these shares. -----END PRIVACY-ENHANCED MESSAGE-----