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