0001127602-17-018623.txt : 20170518
0001127602-17-018623.hdr.sgml : 20170518
20170518153223
ACCESSION NUMBER: 0001127602-17-018623
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170301
FILED AS OF DATE: 20170518
DATE AS OF CHANGE: 20170518
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: 17854739
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
2017-03-01
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
2017-03-01
4
M
0
6875
16.00
A
19437
D
Common Stock
2017-05-16
4
M
0
1025
16.00
A
19804
D
Common Stock
2017-05-16
4
M
0
500
16.80
A
20304
D
Common Stock
800
I
By 401(k) Plan
Stock Option (Right to Buy)
16.00
2017-03-01
4
M
0
6875
0
D
2019-02-02
Common Stock
6875
1025
D
Stock Option (Right to Buy)
16.00
2017-05-16
4
M
0
1025
0
D
2019-02-02
Common Stock
1025
0
D
Stock Option (Right to Buy)
16.80
2017-05-16
4
M
0
500
0
D
2019-12-15
Common Stock
500
9500
D
As of May 16, 2017 all stock options awarded on 02/02/09 have been fully exercised.
The stock option is currently exercisable for all 9,500 shares. The options vested in five annual installments of 2,000 shares annually on December 15 of each year, beginning on December 15, 2010 and fully vesting on December 15, 2014.
/s/ Ann K. Lawson
2017-05-18