0001127602-19-034929.txt : 20191213
0001127602-19-034929.hdr.sgml : 20191213
20191213131737
ACCESSION NUMBER: 0001127602-19-034929
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191212
FILED AS OF DATE: 20191213
DATE AS OF CHANGE: 20191213
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: 191284146
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
2019-12-12
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
2019-12-12
4
F
0
58
74.20
D
13233
D
Common Stock
10
I
Son's UGMA/UTMA Account
Includes 169 shares acquired under the Employee Stock Purchase Plan to date.
/s/ Ann K. Lawson, attorney-in-fact for Patrick Madson
2019-12-13