Schedule 13G Page 1 of 5
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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.
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(Name of Issuer)
COMMON STOCK - $1.00 PAR VALUE
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(Title of Class of Securities)
301309100
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(CUSIP Number)
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(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
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1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
DONALD L. CAMPBELL #500 24 0720
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2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) NOT APPLICABLE
(b) NOT APPLICABLE
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3. SEC Use Only
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4. Citizenship or Place of Organization UNITED STATES CITIZEN
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Number of 5. Sole Voting Power 215, 589
Shares -------------------------------------------------------------------
Beneficially 6. Shared Voting Power 0
Owned by -------------------------------------------------------------------
Each 7. Sole Dispositive Power 215, 589
Reporting -------------------------------------------------------------------
Person With 8. Shared Dispositive Power 0
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9. Aggregate Amount Beneficially Owned by Each Reporting Person 215,589
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10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares
(See Instructions) N/A
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11. Percent of Class Represented by Amount in Row (9) 5.2%
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12. Type of Reporting Person (See Instructions)
IN
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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 Pursuant to
Rule 13d-1 (c) of the Securities and Exchange Act of 1934, as
amended. It is filed by the following person: Donald L.
Campbell ("Mr. Campbell").
(b) Address of Principal Business Office or, if none, Residence:
The business address for Mr. Campbell is 132 East High Street,
Jefferson City, Missouri 65101.
(c) Citizenship: Mr. Campbell is a United States citizen
(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:
Not applicable.
ITEM 4: Ownership (as of December 31, 2004)
Amount beneficially owned: Mr. Campbell may be deemed the beneficial owner of
(i) 155,178 shares owned of record by Campbell Family L. P., which currently
holds all shares previously owned of record by Mr. Campbell and his wife, and
(ii) 55,699 shares held in the Donald L. Campbell Tr u/a Sept. 27, 1997 Donald
L. Campbell Trust, and (iii) 4,712 shares owned solely by Mr. Campbell. Mr.
Campbell has sole voting and investment power over all the shares owned.
Page 4 of 5 Pages
(b) Percent of class: The shares identified in paragraph (a) above
as being beneficially owned by Mr. Campbell represent 5.2 % 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: 215,589
shares.
(ii) shared power to vote or to direct the vote: - 0 -
shares.
(iii) sole power to dispose or to direct the disposition of:
215,589 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.
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.
Not applicable.
ITEM 9: Notice of Dissolution of Group.
Not applicable.
Page 5 of 5 Pages
ITEM 10: Certification.
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.
Dated: February 10, 2005
BY: /s/ Donald L. Campbell
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Donald L. Campbell