4 1 edgar.htm 4 Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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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).

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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Filed By
Romeo and Dye's
Section 16 Filer
www.section16.net



1. Name and Address of Reporting Person*

Erickson, David A.

2. Issuer Name and Ticker or Trading Symbol
BNCCORP, Inc. (BNCC)

6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
X Director                                       10% Owner
    Officer (give title below)          Other (specify below)

                                                  

(Last)      (First)     (Middle)

322 E. Main Avenue
 

3. I.R.S. Identification Number
of Reporting Person,
if an entity (voluntary)

 

4. Statement for
Month/Day/Year
03/07/2003

(Street)

Bismarck , ND 58501

5. If Amendment,
Date of Original
(Month/Day/Year)
 
7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
    Form filed by More than One Reporting Person

(City)     (State)     (Zip)

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 3)

2. Trans-
action
Date
(Month/ Day/
Year)

2A. Deemed
Execution
Date,
if any
(Month/Day/
Year)

3. Trans-
action Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 & 5)

5. Amount of
Securities
Beneficially
Owned Follow-
ing Reported Transactions(s)
(Instr. 3 & 4)

6. Owner-
ship Form:
Direct (D)
or Indirect (I)
(Instr. 4)

7. Nature of Indirect
Beneficial Ownership
(Instr. 4)

Code

V

Amount

(A)
or
(D)

Price

Common Stock

03/07/03

 

S

 

25,000

D

8.40

58,700

D

 

Common Stock

 

 

 

 

 

 

 

300

I

Grandchild

Common Stock

 

 

 

 

 

 

 

38,871(1)

I

401K

Common Stock

 

 

 

 

 

 

 

38,820

I

Spouse

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).

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 control number

FORM 4 (continued)

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security

(Instr. 3)

2. Conver-
sion or
Exercise
Price of Derivative Security

3. Trans-
action Date

(Month/
Day/
Year)

3A. Deemed
Execution
Date,
if any
(Month/
Day/
Year)

4. Trans-
action
Code

(Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D)

(Instr. 3, 4 & 5)

6. Date Exercisable
and Expiration
Date
(Month/Day/
Year)

7. Title and Amount of Underlying Securities
(Instr. 3 & 4)

8. Price of Derivative Security
(Instr. 5)

9. Number of
Derivative
Securities
Beneficially
Owned
Following
Reported Transaction(s)
(Instr. 4)

10. Owner-
ship Form
of Deriv-
ative
Security:
Direct (D)
or Indirect (I)
(Instr. 4)

11. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

(A)

(D)

Date Exer-cisable

Expira-
tion
Date

Title

Amount or Number of
Shares

Explanation of Responses:

(1) The reporting person has not acquired any shares of BNCCORP common stock under the BNCCORP 401(k) Plan since becoming a reporting person.

  By: /s/ Shawn Cleveland Goll
             Attroney in Fact
**Signature of Reporting Person
03/07/2003
Date

**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.

 


	POWER OF ATTORNEY

Know all by these present, that the undersigned hereby constitutes and appoints Shawn Cleveland Goll,
Brenda Rebel, and Annette Eckroth, each acting and signing singly, the undersigned's true and lawful
attorney-in-fact to:

		(1)	execute for and on behalf of the undersigned, in the undersigned's capacity as an
			officer and/or director of BNCCORP, Inc. ("BNC"), Forms 3, 4 and 5 in accordance
			with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

		(2)	do and perform any and all acts for and on behalf of the undersigned which may be
			necessary or desirable to complete and execute any such Form 3, 4 or 5 and timely
			file such form with the United States Securities Exchange Commission and any stock
			exchange or similar authority; and

		(3)	take any other action of any type whatsoever in connection with the foregoing
			which, in the opinion of such attorney-in-fact, may be of benefit to, in the best
			interest of, or legally required by, the undersigned, it being understood that
			the documents executed by such attorney-in-fact on behalf of the undersigned
			pursuant to this Power of Attorney shall be in such form and shall contain such
			terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's
			discretion.

The undersigned hereby grants to such attorney-in-fact full power and authority to do and perform any and
every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the
rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could
do if personally present, with full power of substitution or revocation, hereby ratifying and confirming
all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do
or cause to be done by virtue of this power of attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorney-in-fact, in serving in such capacity at the
request of the undersigned, is not assuming, nor is BNC assuming, any of the undersigned's responsibilities
to comply with Section 16 of the Securities Exchange Act of 1934.

Each of the persons so appointed by the undersigned as attorney-in-fact shall have the power and authority
to act as if they were the only attorney-in-fact so appointed.  Shawn Cleveland Goll shall have primary
responsibility under this Power of Attorney, but, in the case of her unavailability or incapacity to act,
the two remaining appointees shall be empowered to act in her absence.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required
to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities
issued by BNC, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing
ttorney-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 17th day
of August, 2002.




				/s/ David A. Erickson


				David A. Erickson