[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instructions 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL 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(f) of the Investment Company Act of 1940
____________________________________________________________________________
1. Name and Address of Reporting Person*
Herpich Mark A.
- -------------------------------
(Last) (First) (Middle)
3225 Willowood Circle
- -------------------------------
(Street)
Manhattan, KS 66502
- -----------------------------
(City) (State) (Zip)
___________________________________________________________________________
2. Issuer Name and Ticker or Trading Symbol
MNB Bancshares, Inc. (MNBB)
____________________________________________________________________________
3. IRS or Social Security
Number of Reporting
Person (Voluntary)
____________________________________________________________________________
4. Statement for
Month/Year
12/1999
____________________________________________________________________________
5. If Amendment,
Date of Original
(Month/ Year)
____________________________________________________________________________
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[X] Officer [ ] Other (specify below)
(give title below) Chief Financial Officer (1)
____________________________________________________________________________
7. Individual or Joint/Group Filing
(Check Applicable Line)
[ ] Form filed by One Reporting Person
[ ] Form filed by more than One Reporting Person
_______________________________________________________________________________
<TABLE>
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. 2. 3. 4.
Title of Security Transaction Date Transaction Code Securities Acquired (A)
(Instr. 3) (Month/Day/Year) (Instr. 8) or Disposed of (D)
(Instr. 3, 4 and 5)
(A) or
Amount (D) Price
Common Stock 8/16/99 (2) A 306
<S> <C> <C> <C>
5. Amount of Securities 6. Ownership Form: 7. Nature of
Beneficially Owned Direct (D) or Indirect
At End of Issuer's Indirect (I) Beneficial
Fiscal Year (Instr. 4) Ownership
(Instr. 3 and 4) (Instr. 4)
6,433 D
<C> <C> <C>
</TABLE>
(Over)
* If the form is filed by more than one reporting person, see Instruction
4(b)(v). SEC 2270 (7-96
________________________________________________________________________________
FORM 5 (continued)
<TABLE>
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Deriva- 2. Conver- 3. Transaction 4. Transaction 5. Number of
tive Security sion or Date Code Derivative
(Instr. 3) Exercise (Instr. 8) Securities
Price of (Month/ Acquired (A)
Derivative Day/ or Disposed of
Security Year) (D)Inst.3,4,5
Stock Options 12.50 (3) 8/16/99 J(2) 116
To Purchase
Common Stock
<S> <C> <C> <C> <C>
6. Date Exercisable 7. Title and Amount of 8. Price of
and Expiration Date Underlying Securities Derivative
(Month/Day/Year) (Instr. 3 and 4) Security
(Instr. 5)
Date
Exer- Expir- Title Amount or
cisable ation Date Number of
Shares
(4) 11/4/08 Common 116
Stock
<C> <C> <C>
9. Number of Deriv- 10. Ownership of 11. Nature of
ative Securities Derivative Indirect
Beneficially Security: Beneficial
Owned at End Direct (D) or Ownership
of Year Indirect (I) (Instr. 4)
(Instr. 4) (Instr. 4)
2,437 D
<C> <C> <C>
</TABLE>
Explanation of Responses:
1. Of Issuer and Issuer's wholly-owned subsidiary, Security National Bank
2. Shares received from 5% stock dividend paid August 16, 1999
3. Exercise price reflects adjustment for stock dividends
4. Grant of stock options under MNB Bancshares, Inc. 1992 Stock Option Plan,
Exercisable in annual 20% increments beginning November 4, 1999.
/s/Mark A. Herpich 2/11/00
_______________________ ______________
** 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.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB Number.
Page 2
SEC 2270 (7-96)
