0001127602-16-065643.txt : 20161101 0001127602-16-065643.hdr.sgml : 20161101 20161101154603 ACCESSION NUMBER: 0001127602-16-065643 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161028 FILED AS OF DATE: 20161101 DATE AS OF CHANGE: 20161101 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NICOLET BANKSHARES INC CENTRAL INDEX KEY: 0001174850 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 000000000 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 111 N WASHINGTON ST CITY: GREEN BAY STATE: WI ZIP: 54301 BUSINESS PHONE: 920 430 1400 MAIL ADDRESS: STREET 1: 111 N WASHINGTON ST CITY: GREEN BAY STATE: WI ZIP: 54301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lawson Ann Kuchera CENTRAL INDEX KEY: 0001664666 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 161964670 MAIL ADDRESS: STREET 1: C/O NICOLET BANKSHARES, INC. STREET 2: 111 NORTH WASHINGTON STREET CITY: GREEN BAY STATE: WI ZIP: 54301 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-10-28 0001174850 NICOLET BANKSHARES INC NCBS 0001664666 Lawson Ann Kuchera C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 Chief Financial Officer Common Stock 2016-10-28 4 F 0 583 38.76 D 13900 D Common Stock 800 I By 401(k) Plan /s/ Ann K. Lawson 2016-11-01