-----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, Go/Oih3QyIrQmAnTmCti7hXkKdnzMRh2IpFXAbUIWAsNxQva/sW1Bw7XLLgO6kcT w6xxcca2Cbz+3A6WQz/0Tw== 0000946275-04-000193.txt : 20040213 0000946275-04-000193.hdr.sgml : 20040213 20040213103823 ACCESSION NUMBER: 0000946275-04-000193 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040213 GROUP MEMBERS: ESOP SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: WELLS FINANCIAL CORP CENTRAL INDEX KEY: 0000934739 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 411799504 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-45455 FILM NUMBER: 04595467 BUSINESS ADDRESS: STREET 1: 53 FIRST ST SW STREET 2: P.O. BOX 310 CITY: WELLS STATE: MN ZIP: 56097 BUSINESS PHONE: 5075533151 MAIL ADDRESS: STREET 1: 53 1ST ST SW STREET 2: PO BOX 310 CITY: WELLS STATE: MN ZIP: 56097 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: WELLS FEDERAL BANK FSB EMPLOYEE STOCK OWNERSHIP PLAN CENTRAL INDEX KEY: 0001106589 IRS NUMBER: 411799262 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 53 FIRST ST SW CITY: WELLS STATE: MN ZIP: 56097 BUSINESS PHONE: 5075533151 MAIL ADDRESS: STREET 1: 53 FIRST ST SW CITY: WELLS STATE: MN ZIP: 56097 SC 13G/A 1 sc13ga_021304esop-0129.txt ESOP SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G 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. 5)* Wells Financial Corp. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 949759 10 4 - -------------------------------------------------------------------------------- (CUSIP Number) December 19, 2003 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this schedule is filed: |X| Rule 13d-1(b) |_| Rule 13d-1(c) |_| Rule 13d-1(d) - --------------- * The remainder of the 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). (Continued on following pages) Page 1 of 4 CUSIP No. 949759 10 4 Schedule 13-G ----------- ------------- 1. Name of Reporting Person S.S. or I.R.S. Identification Number of above person: Wells Federal Bank, fsb Employee Stock Ownership Plan 2. Check the appropriate box if a member of a group* (a) |X| (b) |_| 3. SEC Use Only 4. Citizenship or Place of Organization: Minnesota --------- Number of Shares Beneficially Owned by Each Reporting Person with: 5. Sole Voting Power: -0- ------- 6. Shared Voting Power: 110,948 ------- 7. Sole Dispositive Power: -0- ------- 8. Shared Dispositive Power: 110,948 ------- 9. Aggregate Amount Beneficially Owned by Each Reporting Person: 110,948 ------- 10. Check Box If The Aggregate Amount in Row (9) Excludes Certain Shares* |_| 11. Percent of Class Represented by Amount in Row 9: 9.6% --- 12. Type of Reporting Person*: EP -- * SEE INSTRUCTION Page 2 of 4 Item 1(a) Name of Issuer: Wells Financial Corp. --------------- --------------------- Item 1(b) Address of Issuer's Principal Executive Offices: ------------------------------------------------ 53 First Street, S.W. Wells, Minnesota 56097 Item 2(a) Name of Person Filing: ---------------------- Wells Federal Bank, fsb Employee Stock Ownership Plan Item 2(b) Address of Principal Business Office: Same as Item 1(b) ------------------------------------ ----------------- Item 2(c) Citizenship: Minnesota ------------ --------- Item 2(d) Title of Class of Securities: Common Stock ----------------------------- ------------ Item 2(e) CUSIP Number: 949759 10 4 ------------- ----------- Item 3 Check whether the person filing is a: ------------------------------------- Item 3(f) X Employee Benefit Plan, in accordance with ---- Rule 13d-1(b)(1)(ii)(F). Item 3(j) X Group, in accordance with Rule 13d- ---- 1(b)(1)(ii)(J). Item 3(a)(b)(c)(d)(e)(g)(h)(i) - not applicable. Item 4(a) Amount Beneficially Owned: 110,948 ------------------------- ------- Item 4(b) Percent of Class: 9.6% ---------------- ---- Item 4(c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote -0- ------- (ii) shared power to vote or to direct the vote 110,948 ------- (iii) sole power to dispose or to direct the disposition of -0- ------- (iv) shared power to dispose or to direct the disposition of 110,948 ------- Page 3 of 4 Item 5 Ownership of Five Percent or Less of 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. ------ This Schedule 13G is being filed on behalf of the Employee Stock Ownership Plan ("ESOP") identified in Item 2(a) by the Plan Committee and the Plan Trustee both filing under the Item 3(f) and 3(j) classifications. Exhibit A contains a disclosure of the voting and dispositive powers over shares of the issuer held directly by these entities exclusive of those shares held by the ESOP as well as identification of members of these groups. Item 9 Notice of Dissolution of Group. ------------------------------- Not applicable Item 10 Certification. -------------- By signing below, I certify that, to the best of my knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or a s a participant in any transaction having such purpose or effect. Page 4 of 4 SIGNATURE: After reasonable inquiry and to the best of my knowledge and belief, as a member of both the Plan Committee and Trustee Committee, I certify that the information set forth in this statement is true, complete and correct. - --------------------------------- ---------------------------- Dale E. Stallkamp Date /s/Randel I. Bichler February 12, 2004 - --------------------------------- ---------------------------- Randel I. Bichler Date /s/Richard A. Mueller February 12, 2004 - --------------------------------- ---------------------------- Richard A. Mueller Date Exhibit A - --------- Identification of Members of Group ---------------------------------- Shares of common stock of the issuer are held in trust for the benefit of participating employees by the ESOP Plan Trustee. The Plan Trustee shares voting and dispositive power with the Plan Committee. By the terms of the Plan, the Plan Trustee votes stock allocated to participant accounts as directed by participants. Stock held by the Trust, but not yet allocated is voted by the Plan Trustee as directed by the Plan Committee. Investment direction is exercised by the Plan Trustee as directed by the Plan Committee. The Plan Committee and the Plan Trustee share voting and dispositive power with respect to the unallocated stock held by the ESOP pursuant to their fiduciary responsibilities under Section 404 of the Employee Retirement Income Security Act of 1974, as amended. Members of the Plan Committee and Trustee Committee and their beneficial ----------------------------------------------------- ownership of shares of common stock of the issuer exclusive of membership on the Plan Committee and Trustee Committee and of shares beneficially owned as a Participant in the Plan are as follows: Beneficial Beneficial Ownership Name Ownership (1) as Plan Participant ---- ------------- ------------------- Dale E. Stallkamp 28,000 -0- Randel I. Bichler 14,448 -0- Richard A. Mueller 15,940 -0- - ---------------- (1) Beneficial ownership as of February 12, 2004. Includes shares of common stock of issuer owned in conjunction with family members. The Plan Committee and Plan Trustee(s) disclaims ownership of these shares in conjunction with the exercise of their fiduciary duties as members of the Plan Committee and Plan Trustee Committee. -----END PRIVACY-ENHANCED MESSAGE-----