<SEC-DOCUMENT>0000897101-12-000184.txt : 20120213
<SEC-HEADER>0000897101-12-000184.hdr.sgml : 20120213
<ACCEPTANCE-DATETIME>20120213121220
ACCESSION NUMBER:		0000897101-12-000184
CONFORMED SUBMISSION TYPE:	SC 13G/A
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20120213
DATE AS OF CHANGE:		20120213

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Hansen Robert D.
		CENTRAL INDEX KEY:			0000845212

	FILING VALUES:
		FORM TYPE:		SC 13G/A

	MAIL ADDRESS:	
		STREET 1:		18260 E. SIOUX VISTA DRIVE
		CITY:			JORDAN
		STATE:			MN
		ZIP:			55352

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HANSEN ROBERT D
		DATE OF NAME CHANGE:	19890109

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Electromed, Inc.
		CENTRAL INDEX KEY:			0001488917
		STANDARD INDUSTRIAL CLASSIFICATION:	ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
		IRS NUMBER:				411732920

	FILING VALUES:
		FORM TYPE:		SC 13G/A
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	005-85992
		FILM NUMBER:		12596748

	BUSINESS ADDRESS:	
		STREET 1:		500 SIXTH AVENUE NW
		CITY:			NEW PRAGUE
		STATE:			MN
		ZIP:			56071
		BUSINESS PHONE:		952-758-9299

	MAIL ADDRESS:	
		STREET 1:		500 SIXTH AVENUE NW
		CITY:			NEW PRAGUE
		STATE:			MN
		ZIP:			56071
</SEC-HEADER>
<DOCUMENT>
<TYPE>SC 13G/A
<SEQUENCE>1
<FILENAME>elmd120568rhansen_sc13ga.htm
<DESCRIPTION>AMENDMENT NO. 1 TO SCHEDULE 13G
<TEXT>
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<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt"><B>&nbsp;</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>SECURITIES
AND EXCHANGE COMMISSION</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>Washington,
D.C. 20549</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>&nbsp;</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>SCHEDULE 13G</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>&nbsp;</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>Under the Securities
Exchange Act of 1934</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>(Amendment
No. 1)*</B></FONT></P>

<P STYLE="font: 12pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt"><B>&nbsp;</B></FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt"><B>&nbsp;</B></FONT></P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse; font-size: 12pt">
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    <TD COLSPAN="3" STYLE="border-bottom: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt; text-align: center">Electromed, Inc.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">(Name of Issuer)</TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="3" STYLE="padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt; font-family: Times New Roman,serif; text-align: center">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="3" STYLE="border-bottom: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt; text-align: center">Common Stock</TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">(Title of Class of Securities)</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 20%; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="width: 59%; padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif; text-align: center">&nbsp;</TD>
    <TD STYLE="width: 21%; padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt; text-align: center">285409 108</TD>
    <TD STYLE="padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">(CUSIP Number)</TD>
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif; text-align: center">&nbsp;</TD>
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="border-bottom: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">December 31, 2011</TD>
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-top: 4.5pt; padding-bottom: 2.7pt; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">(Date of Event Which Requires Filing of this Statement)</TD>
    <TD STYLE="font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD></TR>
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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.1pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.1pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">Check the appropriate
box to designate the rule pursuant to which this Schedule is filed:</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 0 0.5in; text-align: justify"><FONT STYLE="font-family: Wingdings; letter-spacing: -0.15pt">o</FONT>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rule
13d-1(b)</P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 0 0.5in; text-align: justify"><FONT STYLE="font-family: Wingdings; letter-spacing: -0.15pt">o</FONT>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rule
13d-1(c)</P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 0 0.5in; text-align: justify"><FONT STYLE="font-family: Wingdings; letter-spacing: -0.15pt">x</FONT>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Rule
13d-1(d)</P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">*The remainder
of this cover page shall be filled out for a reporting person&rsquo;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.</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">The information
required on the remainder of this cover page shall not be deemed to be &ldquo;filed&rdquo; for the purpose of Section 18 of the
Securities Exchange Act of 1934 (&ldquo;Act&rdquo;) 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).</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt">Page 1 of 5 Pages</FONT></P>

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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>SCHEDULE 13G</B></FONT></P>

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    <TD STYLE="width: 37%; border: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;CUSIP No. 285409 108</TD>
    <TD STYLE="width: 29%; border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD>
    <TD STYLE="width: 34%; border: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;Page 2 of 4 Pages</TD></TR>
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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>1</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-right: 6pt; padding-bottom: 2.7pt; padding-left: 6pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">names of reporting persons</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; padding-right: 6pt; padding-left: 6pt">
        <P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 2.7pt"><FONT STYLE="letter-spacing: -0.15pt">Robert D. Hansen</FONT></P>
        <P STYLE="font: 12pt Times New Roman,serif; margin: 0 0 2.7pt"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>2</B></FONT></TD>
    <TD COLSPAN="3" STYLE="border-top: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">check the appropriate box if a member of a group (see instructions)*</FONT></TD>
    <TD STYLE="border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt; text-align: right"><FONT STYLE="letter-spacing: -0.15pt">(a) <FONT STYLE="font-family: Wingdings">o</FONT>&nbsp;</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-right: 6pt; padding-left: 6pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-right: 6pt; padding-left: 6pt">&nbsp;</TD>
    <TD STYLE="border-right: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-right: 6pt; padding-left: 6pt; text-align: right"><FONT STYLE="letter-spacing: -0.15pt">(b) <FONT STYLE="font-family: Wingdings">o</FONT>&nbsp;</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>3</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">&nbsp;&nbsp;&nbsp;sec use only</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>4</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">citizenship or place of organization</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid; border-bottom: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: Black 1pt solid; border-bottom: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;USA</TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="2" ROWSPAN="6" STYLE="border-left: Black 0.5pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt; text-align: center"><FONT STYLE="letter-spacing: -0.1pt">NUMBER OF<BR>
SHARES<BR>
BENEFICIALLY<BR>
OWNED BY<BR>
EACH<BR>
REPORTING<BR>
PERSON<BR>
WITH</FONT></TD>
    <TD STYLE="border-left: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>5</B></FONT></TD>
    <TD COLSPAN="2" STYLE="border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">&nbsp;&nbsp;&nbsp;sole voting power</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="border-right: Black 1pt solid; border-bottom: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;592,355 (1)</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-left: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>6</B></FONT></TD>
    <TD COLSPAN="2" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">&nbsp;&nbsp;&nbsp;shared voting power</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;0</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>7</B></FONT></TD>
    <TD COLSPAN="2" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">sole dispositive power</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">592,355 (1)</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD COLSPAN="2" STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD STYLE="border-top: windowtext 1pt solid; border-left: windowtext 1pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>8</B></FONT></TD>
    <TD COLSPAN="2" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">shared dispositive power</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: center">&nbsp;</TD>
    <TD STYLE="border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;0</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>9</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt"><FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">&nbsp;&nbsp;&nbsp;aggregate amount beneficially owned by each reporting person</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">592,355 (1)</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>10</B></FONT></TD>
    <TD COLSPAN="3" STYLE="border-top: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">check if the aggregate amount in row (9) excludes certain shares (see instructions)</FONT></TD>
    <TD STYLE="border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; font: 10pt Wingdings; padding-top: 4.5pt; padding-bottom: 2.7pt; text-align: right">o&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>11</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">percent of class represented by amount in row (9)</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt; border-left: Black 0.5pt solid">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: windowtext 1pt solid; border-left: windowtext 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;7.6% (2)</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-top: windowtext 1pt solid; border-left: Black 0.5pt solid; font: bold 10pt Times New Roman,serif; padding-top: 4.5pt; padding-right: 6pt; padding-left: 6pt"><FONT STYLE="letter-spacing: -0.2pt"><B>12</B></FONT></TD>
    <TD COLSPAN="4" STYLE="border-top: Black 1pt solid; border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;<FONT STYLE="font-variant: small-caps; letter-spacing: -0.1pt">type of reporting person (see instructions)</FONT></TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="border-bottom: windowtext 1pt solid; border-left: Black 0.5pt solid; font: 12pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;</TD>
    <TD COLSPAN="4" STYLE="border-right: Black 1pt solid; border-bottom: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman,serif; padding-top: 4.5pt; padding-bottom: 2.7pt">&nbsp;&nbsp;&nbsp;IN</TD></TR>
<TR>
    <TD STYLE="width: 10%">&nbsp;</TD>
    <TD STYLE="width: 5%">&nbsp;</TD>
    <TD STYLE="width: 10%">&nbsp;</TD>
    <TD STYLE="width: 65%">&nbsp;</TD>
    <TD STYLE="width: 10%">&nbsp;</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 0 0.25in; text-align: justify; text-indent: -0.25in"><FONT STYLE="letter-spacing: -0.15pt"><SUP>&nbsp;</SUP></FONT></P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse; font-size: 10pt">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 5%; font-family: Times New Roman,serif; text-align: justify">(1)</TD>
    <TD STYLE="width: 95%; font-family: Times New Roman,serif; text-align: justify">Includes 21,000 shares which may be purchased upon exercise of warrants exercisable within 60 days of the date hereof, 152,415 shares pledged as collateral under a secured promissory note, and 100,000 shares pledged pursuant to a lending arrangement.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; text-align: justify">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; text-align: justify">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; text-align: justify">(2)&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; text-align: justify">The percentage is based upon 8,101,085 shares of common stock outstanding as of November 8, 2011, as reported by the Issuer in its latest Quarterly Report on Form 10-Q, as filed with the Securities and Exchange Commission on November 10, 2011, and 21,000 shares of common stock that may be acquired by the Reporting Person upon the exercise of warrants exercisable within 60 days, which are deemed outstanding in accordance with Rule 13d-3(d)(1) under the Exchange Act. </TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman,serif; margin: 0 0 0 0.25in; text-align: justify; text-indent: -0.25in"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

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<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse; font-size: 12pt">
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 1(a)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Name of Issuer:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="width: 3%; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="width: 3%; font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="width: 84%; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Electromed, Inc.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 1(b)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Address of Issuer&rsquo;s Principal Executive Offices:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">500 Sixth Avenue NW</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">New Prague, MN 56071</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 2(a)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Name of Person Filing:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Robert D.&nbsp; Hansen</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 2(b)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Address of Principal Business Office or, if None, Residence:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">18260 E. Sioux Vista Drive</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Jordan, MN 55352</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 2(c)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Citizenship:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">USA</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 2(d)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Title of Class of Securities:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Common Stock</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 2(e)</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">CUSIP Number:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">285409 108</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 3</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">If this statement is filed pursuant to &sect;&sect; 240.13d-1(b), or 240.13d-2(b) or (c), check&nbsp; whether the person filing is a:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(a)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">Broker or dealer registered under Section 15 of the Act.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(b)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">Bank as defined in Section 3(a)(6) of the Act.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(c)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">Insurance company as defined in Section 3(a)(19) of the Act.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(d)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">Investment company registered under Section 8 of the Investment Company Act of 1940.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(e)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">An investment adviser in accordance with &sect; 240.13d-1(b)(1)(ii)(E).</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(f)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">An employee benefit plan or endowment fund in accordance with &sect; 240.13d-1(b)(1)(ii)(F).</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(g)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">A parent holding company or control person in accordance with &sect; 240.13d-1(b)(1)(ii)(G).</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(h)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(i)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">A church plan that is excluded from the definition of an investment  company under Section 3(c)(14) of the Investment Company Act.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(j)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">A non-U.S. institution in accordance with &sect; 240.13d-1(b)(1)(ii)(J);</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">(k)</TD>
    <TD STYLE="font: bold 10pt Wingdings">o</TD>
    <TD STYLE="font: 10pt Times New Roman,serif">Group, in accordance with &sect; 240.13d-1(b)(1)(ii)(K).</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt">Page 3 of 5 Pages</FONT></P>

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<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; border-collapse: collapse; font-size: 12pt">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="width: 3%; font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="width: 3%; font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="width: 84%; font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">If filing as a non-U.S. institution in accordance with &sect; 240.13d-1(b)(1)(ii)(J), please specify the type of institution:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 4</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Ownership</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">See Cover Page, Items 5 through 11.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 5</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Ownership of Five Percent or Less of a Class:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif"><FONT STYLE="letter-spacing: -0.15pt">If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following <FONT STYLE="font-family: Wingdings"><B>o</B></FONT></FONT>.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 6</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Ownership of More than Five Percent on Behalf of Another Person:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Not applicable.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 7</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Not applicable.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 8</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Identification and Classification of Members of the Group:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Not applicable.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 9</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Notice of Dissolution of Group:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Not applicable.</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font: bold 10pt Times New Roman,serif">Item 10</TD>
    <TD COLSPAN="3" STYLE="font: bold 10pt Times New Roman,serif">Certifications:</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD STYLE="font-family: Times New Roman,serif">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; font-weight: bold">&nbsp;</TD>
    <TD COLSPAN="3" STYLE="font: 10pt Times New Roman,serif">Not applicable.</TD></TR>
</TABLE>
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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt">Page 4 of 5 Pages</FONT></P>

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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt"><B>SIGNATURE</B></FONT></P>

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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="letter-spacing: -0.15pt">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.</FONT></P>

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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: justify"><FONT STYLE="letter-spacing: -0.15pt">Dated:&nbsp;&nbsp;February
13, 2012</FONT></P>

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<TR STYLE="vertical-align: top">
    <TD STYLE="width: 57%; font: 10pt Times New Roman,serif; text-align: justify">&nbsp;</TD>
    <TD STYLE="width: 43%; border-bottom: windowtext 1pt solid; font: 10pt Times New Roman,serif; text-align: justify">/s/ Robert D. Hansen</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="font-family: Times New Roman,serif; text-align: justify">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman,serif; text-align: justify">Robert D. Hansen</TD></TR>
</TABLE>
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<P STYLE="font: 10pt Times New Roman,serif; margin: 0; text-align: center"><FONT STYLE="letter-spacing: -0.15pt">Page 5 of 5 Pages</FONT></P>

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