0001127602-17-018630.txt : 20170518
0001127602-17-018630.hdr.sgml : 20170518
20170518154648
ACCESSION NUMBER: 0001127602-17-018630
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170516
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: 17854823
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
2017-05-16
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
20304
D
Common Stock
800
I
By 401(k) Plan
Stock Option (Right to Buy)
48.85
2017-05-16
4
A
0
54000
48.85
A
2027-05-16
Common Stock
54000
54000
D
The 54,000 nonqualified options granted will vest in five annual installments of 10,800 shares annually on May 16 of each year, beginning on May 16, 2018 and fully vests on May 16, 2022.
/s/ Ann K. Lawson
2017-05-18