0001127602-20-029087.txt : 20201116 0001127602-20-029087.hdr.sgml : 20201116 20201116150012 ACCESSION NUMBER: 0001127602-20-029087 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201112 FILED AS OF DATE: 20201116 DATE AS OF CHANGE: 20201116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DANIELS MICHAEL E CENTRAL INDEX KEY: 0001243706 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 201315843 MAIL ADDRESS: STREET 1: C/O NICOLET NATIONAL BANK 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 2020-11-12 2020-11-16 0001174850 NICOLET BANKSHARES INC NCBS 0001243706 DANIELS MICHAEL E C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 1 EVP and Secretary Common Stock 2020-11-12 4 A 0 882 65.70 A 73112 D Common Stock 2020-11-12 4 F 0 352 65.70 D 72760 D Common Stock 6252 I By 401(k) Plan Common Stock 9803 I By Spouse This report on Form 4/A amends the Form 4 filed by the reporting person on November 16, 2020. This report on Form 4/A is being filed to correct the total beneficial ownership following an award and forfeit of shares on November 12, 2020. Includes 116 shares acquired under the Employee Stock Purchase Plan since the reporting person's previous Form 4 filing on January 28, 2020. The reporting person owns 335 shares total in the Employee Stock Purchase Plan. /s/ Ann K. Lawson, as attorney-in-fact for Michael E. Daniels 2020-11-16