0001127602-20-017356.txt : 20200520 0001127602-20-017356.hdr.sgml : 20200520 20200520162702 ACCESSION NUMBER: 0001127602-20-017356 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200519 FILED AS OF DATE: 20200520 DATE AS OF CHANGE: 20200520 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McClone Dustin James CENTRAL INDEX KEY: 0001702968 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 20898447 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 2020-05-19 0001174850 NICOLET BANKSHARES INC NCBS 0001702968 McClone Dustin James C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 Common Stock 2020-05-19 4 A 0 795 50.34 A 1452 D Common Stock 638 I By Nicolet National Bank Deferred Compensation Plan for Non-employee Directors Common Stock 0 I By RMD Management Group, LLC Represents the holdings of RMD Management Group, LLC, of which the reporting person is a member. The reporting person disclaims beneficial ownership of registrant common stock held by RMD Management Group, LLC except to the extent of his pecuniary interest. /s/ Ann K. Lawson, as attorney-in-fact for Dustin J. McClone 2020-05-20