0001127602-23-013293.txt : 20230420 0001127602-23-013293.hdr.sgml : 20230420 20230420161941 ACCESSION NUMBER: 0001127602-23-013293 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230418 FILED AS OF DATE: 20230420 DATE AS OF CHANGE: 20230420 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McClone Dustin James CENTRAL INDEX KEY: 0001702968 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 23833353 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 X0407 4 2023-04-18 0001174850 NICOLET BANKSHARES INC NIC 0001702968 McClone Dustin James C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 0 Common Stock 2892 D Common Stock 2023-04-18 4 A 0 107 62.83 A 1113 I By Nicolet National Bank Deferred Compensation Plan for Non-employee Directors Mr. McClone acquired 107 shares in the Nicolet National Bank Deferred Compensation Plan for Non-employee Directors by deferring his first quarter 2023 earned board fees. /s/ H. Phillip Moore, Jr., as attorney-in-fact for Dustin J. McClone 2023-04-20