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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
- ----------- Washington D.C. 20549 --------------------------------
FORM 3 OMB APPROVAL
- ----------- INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES --------------------------------
OMB Number: 3235-0104
Filed pursuant to Section 16(a) of the Securities Expires: December 31, 2001
Exchange Act of 1934, Section 17(a) of the Public Estimated average burden
Utility Holding Company Act of 1935 or Section hours per response..........0.5
30(f) of the Investment Company Act of 1940 --------------------------------
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1. Name and Address of Reporting Person*|2. Date of Event |4. Issuer Name and Ticker or Trading Symbol
| Requiring Statement |
| (Month/Day/Year) | Tri-County Bancorp, Inc TRIC
| |----------------------------------------------------------------
Guth Joe P. | May 1, 1999 |5. Relationship of Reporting |6. If Amendment,
- ----------------------------------------|--------------------------| Person(s) to Issuer | Date of Original
(Last) (First) (Middle) |3. IRS or Social Security | (Check all applicable) | (Month/Day/Year)
| Number of Reporting | |
RR 3, Box 61 | Person (Voluntary) | ___Director ___10% Owner |-----------------------
- ----------------------------------------| | _X_Officer (give ___Other (specify |7. Individual or Joint/
(Street) | ###-##-#### | title below) below) | Group Filing
| | | _X_ Filed by one
Torrington WY 82240 | | Executive Vice President | ___ Filed by group
- ----------------------------------------|--------------------------|----------------------------------------------------------------
(City) (State) (Zip) | TABLE I - Non-Derivative Securities Beneficially Owned
- ----------------------------------------|-------------------------------------------------------------------------------------------
1. Title of Security |2. Amount of Securities |3. Ownership |4. Nature of Indirect Beneficial
(Instr. 4) | Beneficially Owned | Form: Direct | Ownership (Instr. 5)
| (Instr. 4) | (D) or Indirect |
| | (I) (Instr. 5) |
- -------------------------------------------------|------------------------|-------------------|-------------------------------------
| | |
- -------------------------------------------------|------------------------|-------------------|-------------------------------------
| | |
- -------------------------------------------------|------------------------|-------------------|-------------------------------------
| | |
- -------------------------------------------------|------------------------|-------------------|-------------------------------------
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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).
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FORM 3 (continued) TABLE II - Derivative Securities Beneficially Owned (e.g. puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security |2. Date Exer- |3. Title and Acount of Securities |4. Conver- |5. Ownership |6. Nature of
(Instr. 4) | cisable and | Underlying Derivative Security | sion or | Form of r | Indirect
| Expiration Date | (Instr. 4) | Exercise | Derivative | Beneficial
| (Month/Day/Year)| | Price of | Security: | Ownership
| | | Derivative| Direct(D) | (Instr. 5)
|-------------------|----------------------------------| Security | or Indirect|
|Date |Expiration | | Amount or | | (I) |
|Exer- | Date | Title | Number of | | (Instr. 5)|
|cisable| | | Shares | | |
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
| | | | | | |
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
| | | | | | |
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
| | | | | | |
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
| | | | | | |
- --------------------------------|-------|-----------|---------------------|------------|-------------|--------------|---------------
Explanation of Responses:
/s/Joe P. Guth June 29, 1999
------------------------------- ------------------
**Signature of Reporting Person Date
* Intentional misstatement 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.
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