0001174850-21-000082.txt : 20211122
0001174850-21-000082.hdr.sgml : 20211122
20211122162928
ACCESSION NUMBER: 0001174850-21-000082
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211118
FILED AS OF DATE: 20211122
DATE AS OF CHANGE: 20211122
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: 211432900
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
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2021-11-18
0
0001174850
NICOLET BANKSHARES INC
NCBS
0001666799
Madson Patrick Joseph
C/O NICOLET BANKSHARES, INC.
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
0
1
0
0
SVP-Wealth Mgmt-NicoletNatBank
Common Stock
2021-11-18
4
F
0
49
73.85
D
6797
D
Shares withheld to satisfy tax obligation of vested restricted stock.
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 last Form 4 filing, November 15, 2021.
/s/ H. Phillip Moore, Jr., as attorney-in-fact for Patrick Madson
2021-11-22