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