0001127602-21-019569.txt : 20210610 0001127602-21-019569.hdr.sgml : 20210610 20210610105110 ACCESSION NUMBER: 0001127602-21-019569 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210513 FILED AS OF DATE: 20210610 DATE AS OF CHANGE: 20210610 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Radzak Eric Peter CENTRAL INDEX KEY: 0001664661 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 211007259 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 2021-05-13 0001174850 NICOLET BANKSHARES INC NCBS 0001664661 Radzak Eric Peter C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 Corp Dev Off Nicolet Nat Bank Common Stock 1184 D Stock Option (Right to Buy) 78.67 2021-05-13 4 A 0 10000 78.67 A 2031-05-13 Common Stock 10000 10000 D Includes an additional 77 shares acquired under the Employee Stock Purchase since the reporting person's last Form 4 filing on November 16, 2020. The reporting person owns a total of 523 shares in the Employee Stock Purchase Plan as of the date of this report. The nonqualified options vest in five annual installments of 2,000 shares on May 13 of each year, beginning on May 13, 2022 and will fully vest on May 13, 2026. /s/ Marc T. Lambrecht, as attorney-in-fact for Eric P. Radzak 2021-06-10