0001127602-17-030040.txt : 20171019
0001127602-17-030040.hdr.sgml : 20171019
20171019113313
ACCESSION NUMBER: 0001127602-17-030040
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171017
FILED AS OF DATE: 20171019
DATE AS OF CHANGE: 20171019
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LONG DONALD J JR
CENTRAL INDEX KEY: 0001243725
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 171144054
MAIL ADDRESS:
STREET 1: C/O NICOLET NATIONAL BANK
STREET 2: 111 NORTH WASHINGTON STREET
CITY: GREEN BAY
STATE: WI
ZIP: 54301
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
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2017-10-17
0001174850
NICOLET BANKSHARES INC
NCBS
0001243725
LONG DONALD J JR
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
Common Stock
2017-10-17
4
A
0
150
59.70
A
2660
I
By Nicolet National Bank Deferred Compensation Plan For Non-employee Directors
Common Stock
99521
D
/s/ Ann K. Lawson, as attorney-in-fact for Donald Long, Jr.
2017-10-19