0001127602-20-002211.txt : 20200123 0001127602-20-002211.hdr.sgml : 20200123 20200123121903 ACCESSION NUMBER: 0001127602-20-002211 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200121 FILED AS OF DATE: 20200123 DATE AS OF CHANGE: 20200123 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Smith Oliver Pierce CENTRAL INDEX KEY: 0001702992 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 20541250 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 2020-01-21 0001174850 NICOLET BANKSHARES INC NCBS 0001702992 Smith Oliver Pierce C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 Common Stock 2020-01-21 4 A 0 74 71.48 A 1173 I By Nicolet National Bank Deferred Compensation Plan For Non-employee Directors Common Stock 440234 D An adjustment of 3 shares omitted from the reporting person's original Form 3 filed on May 2, 2017. These shares were also omitted from ten Form 4's filed by the reporting person after the original Form 3 was filed. /s/ Ann K. Lawson, as attorney-in-fact for Oliver Pierce Smith 2020-01-23