0001127602-20-028914.txt : 20201113
0001127602-20-028914.hdr.sgml : 20201113
20201113130128
ACCESSION NUMBER: 0001127602-20-028914
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201110
FILED AS OF DATE: 20201113
DATE AS OF CHANGE: 20201113
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lawson Ann Kuchera
CENTRAL INDEX KEY: 0001664666
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 201310365
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
2020-11-10
2020-11-12
0001174850
NICOLET BANKSHARES INC
NCBS
0001664666
Lawson Ann Kuchera
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
Chief Financial Officer
Common Stock
2020-11-10
4
M
0
1000
37.18
A
29983
D
Common Stock
2020-11-10
4
F
0
693
67.95
D
29290
D
Common Stock
2020-11-10
4
M
0
1200
37.18
A
30490
D
Common Stock
2020-11-10
4
S
0
1200
67.68
D
29290
D
Common Stock
800
I
By 401(k) Plan
Stock Option (Right to Buy)
37.18
2020-11-10
4
M
0
1000
0
D
2026-09-20
Common Stock
1000
6000
D
Stock Option (Right to Buy)
37.18
2020-11-10
4
M
0
1200
0
D
2026-09-20
Common Stock
1200
4800
D
This report on Form 4/A amends the Form 4 filed by the reporting person on November 12, 2020. This report on Form 4/A is being filed to correct the amount of shares forfeited at time of exercise of 1,000 nonqualified stock options on November 10, 2020.
The reporting person has not acquired additional shares under the Employee Stock Purchase Plan since the reporting person's last Form 4 filing on November 12, 2020. The reporting person owns 111 shares total in the Employee Stock Purchase Plan which is included in the reporting persons direct beneficial ownership total.
The nonqualified options are currently exercisable to 2,800 shares. The nonqualified options vest in five annual installments of 2,000 shares annually on September 20 of each year, beginning on September 20, 2017 and fully vest on September 20, 2021.
/s/ Ann K. Lawson
2020-11-13