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