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