0001127602-21-017540.txt : 20210520
0001127602-21-017540.hdr.sgml : 20210520
20210520154505
ACCESSION NUMBER: 0001127602-21-017540
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210518
FILED AS OF DATE: 20210520
DATE AS OF CHANGE: 20210520
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dykema John Nicholas
CENTRAL INDEX KEY: 0001664500
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 21944345
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
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2021-05-18
0001174850
NICOLET BANKSHARES INC
NCBS
0001664500
Dykema John Nicholas
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
Common Stock
2021-05-18
4
A
0
642
77.82
A
41305
D
Common Stock
30304
I
By the John & Lisa Dykema 2012 Trust
Common Stock
7812
I
By Nicolet National Bank Deferred Compensation Plan For Non-employee Directors
/s/ Ann K. Lawson, as attorney-in-fact for John N. Dykema
2021-05-20