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