0001127602-16-070937.txt : 20161227
0001127602-16-070937.hdr.sgml : 20161227
20161227161724
ACCESSION NUMBER: 0001127602-16-070937
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160920
FILED AS OF DATE: 20161227
DATE AS OF CHANGE: 20161227
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: Radzak Eric Peter
CENTRAL INDEX KEY: 0001664661
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 162070820
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
2016-09-20
0001174850
NICOLET BANKSHARES INC
NCBS
0001664661
Radzak Eric Peter
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
Corp Dev Off Nicolet Nat Bank
Stock Option (Right to Buy)
37.18
2016-09-20
4
A
0
2500
37.18
A
2026-09-20
Common Stock
2500
2500
D
The nonqualified options vest in five annual installments of 500 shares annually on September 20 of each year, beginning on September 20, 2017 and fully vest on September 20, 2021.
/s/ Ann K. Lawson, as attorney-in-fact for Eric P. Radzak
2016-12-27