0001174850-21-000089.txt : 20211124 0001174850-21-000089.hdr.sgml : 20211124 20211124133126 ACCESSION NUMBER: 0001174850-21-000089 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211122 FILED AS OF DATE: 20211124 DATE AS OF CHANGE: 20211124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Radzak Eric Peter CENTRAL INDEX KEY: 0001664661 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 211444605 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 2021-11-22 0 0001174850 NICOLET BANKSHARES INC NCBS 0001664661 Radzak Eric Peter C/O NICOLET BANKSHARES, INC. 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 0 1 0 0 Corp Dev Off-Nicolet Natl Bank Common Stock 2021-11-22 4 A 0 447 73.21 A 1711 D Restricted shares awarded November 22, 2021. Awarded shares will vest as follows: 1/3 immediate, 1/3 on November 22, 2022, and 1/3 on November 22, 2023. Includes 80 additional shares acquired by Mr. Radzak under the Employee Stock Purchase Plan, since Mr. Radzak's previous Form 4 filing, June 10, 2021. Mr. Radzak owns a total of 603 shares in the Employee Stock Purchase Plan as of the date of this report. /s/ H. Phillip Moore, Jr., as attorney-in-fact for Eric P. Radzak 2021-11-24