0001127602-17-034725.txt : 20171214
0001127602-17-034725.hdr.sgml : 20171214
20171214174337
ACCESSION NUMBER: 0001127602-17-034725
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171212
FILED AS OF DATE: 20171214
DATE AS OF CHANGE: 20171214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Madson Patrick Joseph
CENTRAL INDEX KEY: 0001666799
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 171257087
MAIL ADDRESS:
STREET 1: C/O NICOLET BANKSHARES, INC.
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
2017-12-12
0001174850
NICOLET BANKSHARES INC
NCBS
0001666799
Madson Patrick Joseph
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
SVP-Wealth Mgmt-NicoletNatBank
Common Stock
2017-12-12
4
A
0
537
57.75
A
23300
D
Common Stock
2017-12-12
4
F
0
62
57.75
D
23238
D
Received in exchange for the Issuer's purchase of brokerage books of business.
/s/ Ann K. Lawson, attorney-in-fact for Patrick Madson
2017-12-14