0001127602-16-067461.txt : 20161116
0001127602-16-067461.hdr.sgml : 20161116
20161116171656
ACCESSION NUMBER: 0001127602-16-067461
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161114
FILED AS OF DATE: 20161116
DATE AS OF CHANGE: 20161116
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: 162003179
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
2016-11-14
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
2016-11-14
4
M
0
1065
16.50
A
14965
D
Common Stock
2016-11-14
4
F
0
406
43.25
D
14559
D
Common Stock
800
I
By 401(k) Plan
Stock Option (Right to Buy)
16.50
2016-11-14
4
M
0
1065
0
D
2022-04-10
Common Stock
1065
3935
D
The stock option is currently exercisable as to 1,435 shares. The options vest in ten annual installments of 500 shares annually on April 10 of each year, beginning on April 10, 2012 and fully vesting on April 10, 2021.
/s/ Ann K. Lawson
2016-11-16