0001127602-19-025236.txt : 20190726 0001127602-19-025236.hdr.sgml : 20190726 20190726094349 ACCESSION NUMBER: 0001127602-19-025236 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190724 FILED AS OF DATE: 20190726 DATE AS OF CHANGE: 20190726 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Witczak Eric James CENTRAL INDEX KEY: 0001667436 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 19976174 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 2019-07-24 0001174850 NICOLET BANKSHARES INC NCBS 0001667436 Witczak Eric James C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 EVP - Nicolet National Bank Common Stock 2019-07-24 4 M 0 9000 16.80 A 24389 D Common Stock 2019-07-24 4 F 0 2323 65.09 D 22066 D Common Stock 6783 I By 401(k) Plan Stock Option (Right to Buy) 16.80 2019-07-24 4 M 0 9000 0 D 2019-12-15 Common Stock 9000 0 D Includes 122 shares acquired under the Employee Stock Purchase Plan. The stock option has been fully exercised as of July 24, 2019. 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, as attorney-in-fact for Eric J. Witczak 2019-07-26