FORM 5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ___ Form 3 Holdings Reported ___ Form 4 Transactions Reported
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION 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 |
OMB APPROVAL OMB Number: 3235-0362 Expires: January 31, 2005 Estimated average burden
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1. Name and Address of Reporting Person* McNeil Michael |
2. Issuer Name and Ticker or Trading Symbol HMN Financial, Inc. / HMNF |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable) x Director 10% Ownerx Officer (give title below) Other (specify below) President |
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3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Day/Year December 31, 2002 |
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(Last) (First) (Middle)
1016 Civic Center Drive NW |
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5. If Amendment, Date of Original (Month/Day/Year) |
7. Individual or Joint/Group Filing (Check Applicable Line)Form filed by One Reporting Person Form filed by More than One Reporting Person |
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(Street) Rochester Minnesota 55901 |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date (Month/ Day/Year) |
2A. Deemed Execution Date, if any (Month/ Day/Year) |
3. Transaction Code |
4. Securities Acquired (A) |
5. Amount of Securities Beneficially Owned at the end of Issuer's Fiscal Year |
6. Ownership Form: Direct (D) or Indirect (I) |
7. Nature of Indirect Beneficial Ownership |
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Amount |
(A) or (D) |
Price |
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Common Stock |
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5,000 |
D |
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Common Stock |
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7,400 |
D |
Self - IRA |
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Common Stock |
12/31/02 |
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A |
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997 |
A |
$10.00 |
4,348# |
I |
ESOP Allocation |
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Common Stock |
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3,985* |
I |
401(k) |
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#Number of ESOP shares reflects the 2002 ESOP allocation. |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Derivative Security |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date Day/Year) |
3A. Deemed Execution Date, if any |
4. Transaction Code |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) |
6. Date Exerciseable and Expiration Date |
7. Title and Amount of Underlying Securities |
8. Price of Derivative Security |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) |
10. Ownership Form of Derivative Securities Beneficially Owned at End of Month |
11. Nature of Indirect Beneficial Ownership |
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(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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Option to Buy |
$9.21 |
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50,000# |
D |
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Option to Buy |
$16.13 |
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26,316^ |
D |
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Explanation of Responses: ^ Reflects the grant of options to purchase shares of restricted stock under the HMN Financial, Inc. 2001 Omnibus Stock Plan. The options accelerate vesting provided HMN's ROE for 2002 equals or exceeds 11%. |
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/s/ Timothy Johnson POA for Michael
McNeil |
February 14, 2003 |
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Reminder: |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations |
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See 18 U.S.C. 1001 or 15 U.S.C. 78ff(a). |
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Note: |
File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure |