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