Schedule 13G Page 1 of 5
--------------------------------------------------------------------------------
SEC 1745 POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION
(02-02) CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM
DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER.
--------------------------------------------------------------------------------
OMB APPROVAL
OMB Number: 3235-0145
Expires: December 31, 2005
Estimated average burden
hours per response... 11
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO. 5 )*
EXCHANGE NATIONAL BANCSHARES, INC
--------------------------------------------------------------------------------
(Name of Issuer)
COMMON STOCK - $1.00 PAR VALUE
--------------------------------------------------------------------------------
(Title of Class of Securities)
301309100
--------------------------------------------------------------------------------
(CUSIP Number)
--------------------------------------------------------------------------------
(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 l3d-1(c)
[ ] 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 ("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).
http://www.sec.gov/divisions/corpfin/forms/13g.htm 1/26/2005
Schedule 13G Page 2 of 5
CUSIP No. 301309100
--------------------------------------------------------------------------------
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
EXCHANGE NATIONAL BANCSHARES, 401K PROFIT SHARING TRUST # 44 6007349
--------------------------------------------------------------------------------
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) NOT APPLICABLE
(b) NOT APPLICABLE
--------------------------------------------------------------------------------
3. SEC Use Only
--------------------------------------------------------------------------------
4. Citizenship or Place of Organization MISSOURI
--------------------------------------------------------------------------------
Number of 5. Sole Voting Power 0
Shares -------------------------------------------------------------------
Beneficially 6. Shared Voting Power 0
Owned by -------------------------------------------------------------------
Each 7. Sole Dispositive Power 155,310
Reporting -------------------------------------------------------------------
Person With 8. Shared Dispositive Power 0
--------------------------------------------------------------------------------
9. Aggregate Amount Beneficially Owned by Each Reporting Person 155,310
--------------------------------------------------------------------------------
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares
(See Instructions) N/A
--------------------------------------------------------------------------------
11. Percent of Class Represented by Amount in Row (9) 3.7%
--------------------------------------------------------------------------------
12. Type of Reporting Person (See Instructions)
EP
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
http://www.sec.gov/divisions/corpfin/forms/13g.htm 1/26/2005
Page 3 of 5 Pages
ITEM 1:
(a) Name of Issuer: Exchange National Bancshares, Inc.
(b) Address of Issuer's Principal Executive Offices:
132 East High Street
Jefferson City, Missouri 65101
ITEM 2:
(a) Name of Person Filing: This Schedule 13G is filed by
the Exchange National Bancshares 401K Profit-Sharing
Trust (the "Trust").
(b) Address of Principal Business Office or, if none,
Residence: The business address for the Trust is 132
East High Street, Jefferson City, Missouri 65101.
(c) Citizenship: Missouri
(d) Title of Class of Securities: Common stock, par value
$1.00 per share.
(e) CUSIP No.: 301309 10 0
ITEM 3: If this statement is filed pursuant to Rules 13d-1 (b), or
13d-2 (b), check whether the person filing is a:
(a) (X) Employee Benefit Plan, Pension Fund which is
subject to the provisions of the Employee Retirement
Income Security Act of 1974 or Endowment Fund.
ITEM 4: Ownership (as of December 31, 2004)
(a) Amount beneficially owned: 155,310 shares.
(b) Percent of class: The shares identified in
paragraph (a) above as being beneficially owned by
the Trust represent 3.7% of the 4,169,847 shares
outstanding on December 31, 2004.
(c) Number of shares of which such person has:
(I) sole power to vote or to direct the vote:
0 shares
Page 4 of 5 Pages
(ii) shared power to vote or to direct the vote:
0 shares
(iii) sole power to dispose or to direct the
disposition of: 155,310 shares.
(iv) shared power to dispose or to direct the
disposition of: 0 shares.
ITEM 5: Ownership of Five Percent or Less of a Class.
Not applicable.
ITEM 6: Ownership of More than Five Percent on Behalf of Another Person.
The shares held by the Trust are held for the benefit of the Trust's
participants.
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.
Not applicable.
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 as a
participant in any transaction having such purpose or effect.
Page 5 of 5 Pages
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: February 11, 2005
EXCHANGE NATIONAL BANCSHARES 401K
PROFIT-SHARING TRUST
By The Exchange National Bancshares, Inc.
BY: /s/ Kathleen Bruegenhemke
----------------------------------------
Kathleen Bruegenhemke
Sr. Vice President