0001127602-21-030541.txt : 20211208
0001127602-21-030541.hdr.sgml : 20211208
20211208165128
ACCESSION NUMBER: 0001127602-21-030541
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211208
FILED AS OF DATE: 20211208
DATE AS OF CHANGE: 20211208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Madson Patrick Joseph
CENTRAL INDEX KEY: 0001666799
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 211479266
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
2021-12-08
0001174850
NICOLET BANKSHARES INC
NCBS
0001666799
Madson Patrick Joseph
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
1
SVP-Wealth Mgmt-NicoletNatBank
Common Stock
2021-12-08
4
S
0
900
76.0033
D
6508
D
Includes Mr. Madson's 488 shares owned in the Employee Stock Purchase Plan. Mr. Madson has not acquired additional shares under the Employee Stock Purchase Plan since his previous Form 4 filing, November 24, 2021.
/s/ H. Phillip Moore, Jr., attorney-in-fact for Patrick Madson
2021-12-08