-----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, HuUwuuS/SkS2mK4MZzW5DDa01Vp3mtNcxU2SilKHUsoeXzuTtmnYmCcaTRZubeje kV3jygiPgsegcKhJ5ZZljQ== 0000912057-97-015924.txt : 19970508 0000912057-97-015924.hdr.sgml : 19970508 ACCESSION NUMBER: 0000912057-97-015924 CONFORMED SUBMISSION TYPE: SC 13D PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970507 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COMMUNITY FIRST BANKSHARES INC CENTRAL INDEX KEY: 0000857593 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 460391436 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D SEC ACT: 1934 Act SEC FILE NUMBER: 005-48511 FILM NUMBER: 97597128 BUSINESS ADDRESS: STREET 1: 520 MAIN AVENUE CITY: FARGO STATE: ND ZIP: 58124-0001 BUSINESS PHONE: 7012985600 MAIL ADDRESS: STREET 1: 520 MAIN AVENUE CITY: FARGO STATE: ND ZIP: 58124-0001 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MATHISEN DENNIS M CENTRAL INDEX KEY: 0001038601 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13D BUSINESS ADDRESS: STREET 1: 8433 E CAREFREE DRIVE STREET 2: P O BOX 5511 CITY: CAREFREE STATE: AZ ZIP: 85377 SC 13D 1 SCHEDULE 13D SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D Under the Securities Exchange Act of 1934 (Amendment No. ___ )* Community First Bankshares, Inc. -------------------------------- (Name of Issuer) Common Stock, $0.01 par value ----------------------------- (Title of Class of Securities) 203902 10 1 ----------- (CUSIP Number) Patrick Delaney Lindquist & Vennum P.L.L.P. 4200 IDS Center 80 South Eighth Street Minneapolis, Minnesota 55402 Telephone: (612) 371-3211 -------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) December 18, 1996 ----------------- (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(b)(3) or (4), check the following box. / / NOTE: Six copies of this statement, including all exhibits, should be filed with the Commission. See Rule 13d-1(a) for other parties to whom copies are to be sent. *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). Page 1 of 4 Pages CUSIP No. 203902 10 1 13D Page 2 of 4 Pages ------------- --- --- - ------------------------------------------------------------------------------- (1) Names of Reporting Persons. S.S. or I.R.S. Identification Nos. of Above Persons Dennis M. Mathisen - ------------------------------------------------------------------------------- (2) Check the Appropriate Box if a Member (a) / / of a Group* (b) / / - ------------------------------------------------------------------------------- (3) SEC Use Only - ------------------------------------------------------------------------------- (4) Source of Funds* 00(exchange of stock in a merger) - ------------------------------------------------------------------------------- (5) Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e) / / - ------------------------------------------------------------------------------- (6) Citizenship or Place of Organization UNITED STATES - ------------------------------------------------------------------------------- Number of Shares (7) Sole Voting Beneficially Owned Power 1,629,705 by Each Reporting -------------------------------------------------- Person With (8) Shared Voting Power -0- -------------------------------------------------- (9) Sole Dispositive Power 1,629,705 -------------------------------------------------- (10) Shared Dispositive Power -0- - ------------------------------------------------------------------------------- (11) Aggregate Amount Beneficially Owned by Each Reporting Person 1,629,705 - ------------------------------------------------------------------------------- (12) Check if the Aggregate Amount in Row (11) Excludes Certain Shares* / / - ------------------------------------------------------------------------------- (13) Percent of Class Represented by Amount in Row (11) 9.50% - ------------------------------------------------------------------------------- (14) Type of Reporting Person* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! Item 1. SECURITY AND ISSUER This Statement relates to the Common Stock, par value $.01 per share (the "Common Stock"), of Community First Bankshares, Inc. (the "Company"). The address of the Company is 520 Main Avenue, Fargo, North Dakota 58124-0001. Item 2. IDENTITY AND BACKGROUND (a) Dennis M. Mathisen ("Mr. Mathisen"). (b) 8433 E. Carefree Drive, P.O. Box 5511, Carefree, AZ 85377. (c) Mr. Mathisen's principal occupation is President of Marshall Financial Group, a financial services company, 8433 E. Carefree Drive, P.O. Box 5511, Carefree, AZ 85377. (d) Mr. Mathisen has not been convicted in a criminal proceeding in the last five years. (e) Mr. Mathisen has not been a party to a civil proceeding involving violations of securities laws in the last five years. (f) Mr. Mathisen is a citizen of the United States. Item 3. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION Mr. Mathisen acquired beneficial ownership of 1,629,705 shares of Common Stock of the Company in exchange for 1,278,200 shares of Common Stock held by Mr. Mathisen in Mountain Parks Financial Corp. pursuant to a merger of Mountain Parks Financial Corp. with and into the Company on December 18, 1996. Item 4. PURPOSE OF TRANSACTION Mr. Mathisen has acquired the securities described in Item 3 above for investment purposes. Mr. Mathisen is a member of the Company's board of directors. Mr. Mathisen may, from time to time, (1) acquire additional shares of Common Stock (subject to availability at prices deemed favorable to Mr. Mathisen) in the open market, in privately negotiated transactions, or otherwise, or (2) attempt to dispose of shares of Common Stock in the open market, in privately negotiated transactions or otherwise. Page 3 of 4 Pages --- --- Except as set forth above, Mr. Mathisen has no present plans or intentions that would result in or relate to any of the transactions described in subparagraphs (a) through (j) of Item 4 of Schedule 13D. Item 5. INTEREST IN SECURITIES OF THE ISSUER (a) As of December 18, 1996, Mr. Mathisen beneficially owned 1,629,705 shares of the Common Stock of the Company, which represented 9.50% of the outstanding Common Stock on such date. (b) The responses of the Seller to Items (7) through (11) of the portions of the cover page of this Schedule which relate to beneficial ownership of shares of Common Stock are incorporated herein by reference. (c) Other than the transactions described in Item 3 above, the Seller has not effected any transactions in the Common Stock during the past sixty days. (d) Not applicable. (e) Not applicable. Item 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT TO SECURITIES OF THE ISSUER There are no contracts, arrangements, understandings or relationships between the Purchaser and any person with respect to any securities of the Company. Item 7. MATERIAL TO BE FILED AS EXHIBITS 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. Date: March 28, 1997 /s/ Dennis M. Mathisen ------------------------------ Dennis M. Mathisen Page 4 of 4 Pages --- --- -----END PRIVACY-ENHANCED MESSAGE-----