0001127602-20-027470.txt : 20201023 0001127602-20-027470.hdr.sgml : 20201023 20201023190640 ACCESSION NUMBER: 0001127602-20-027470 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201023 FILED AS OF DATE: 20201023 DATE AS OF CHANGE: 20201023 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Witczak Eric James CENTRAL INDEX KEY: 0001667436 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 201258737 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/A 1 form4a.xml PRIMARY DOCUMENT X0306 4/A 2020-10-23 2020-10-23 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 2020-10-23 4 S 0 2177 64.03 D 22802 D Common Stock 6783 I By 401(k) Plan This report on Form 4/A amends the Form 4 filed by the reporting person on October 23, 2020. This report on Form 4/A is being filed solely to reduce the number of shares beneficially owned to eliminate the shares purportedly acquired on May 13, 2020. Includes 360 shares acquired under the Employee Stock Purchase Plan to date. /s/ Ann K. Lawson, as attorney-in-fact for Eric J. Witczak 2020-10-23