0001174850-21-000083.txt : 20211122
0001174850-21-000083.hdr.sgml : 20211122
20211122164018
ACCESSION NUMBER: 0001174850-21-000083
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: Witczak Eric James
CENTRAL INDEX KEY: 0001667436
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37700
FILM NUMBER: 211433068
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
0001667436
Witczak Eric James
C/O NICOLET BANKSHARES, INC.
111 NORTH WASHINGTON STREET
GREEN BAY
WI
54301
0
1
0
0
Secretary
Common Stock
2021-11-18
4
F
0
65
73.85
D
22087
D
Shares withheld to satisfy tax obligation of vested restricted stock.
Includes Mr. Witczak's 517 shares owned in the Employee Stock Purchase Plan. Mr. Witczak 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 Eric J. Witczak
2021-11-22