0001127602-22-021792.txt : 20220830 0001127602-22-021792.hdr.sgml : 20220830 20220830170607 ACCESSION NUMBER: 0001127602-22-021792 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220826 FILED AS OF DATE: 20220830 DATE AS OF CHANGE: 20220830 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JOHNSON BRENDA L CENTRAL INDEX KEY: 0001942061 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 221215302 MAIL ADDRESS: STREET 1: C/O NICOLET BANKSHARES, INC. STREET 2: 111 N. 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 2022-08-26 0001174850 NICOLET BANKSHARES INC NIC 0001942061 JOHNSON BRENDA L C/O NICOLET NATIONAL BANK 111 N. WASHINGTON STREET GREEN BAY WI 54301 1 Common Stock 2022-08-26 4 A 0 638631 0 A 638631 D Common Stock 2022-08-26 4 A 0 428 77.75 A 639059 D Acquired in connection with the Charter Bankshares, Inc. and Nicolet Bankshares, Inc. merger, effective August 26, 2022. Upon Ms. Johnson's appointment to Nicolet Bankshares, Inc. Board of Directors, effective August 26, 2022, the Company paid Ms. Johnson the Board annual retainer, granted as a restricted stock award with an immediate full vest of 428 shares, as of August 26, 2022. /s/ H. Phillip Moore, Jr., as attorney-in-fact for Brenda L. Johnson 2022-08-30