0001367859-23-000049.txt : 20230123
0001367859-23-000049.hdr.sgml : 20230123
20230123161819
ACCESSION NUMBER: 0001367859-23-000049
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230119
FILED AS OF DATE: 20230123
DATE AS OF CHANGE: 20230123
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BROUCEK JAMES S
CENTRAL INDEX KEY: 0001204872
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33003
FILM NUMBER: 23544677
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Citizens Community Bancorp Inc.
CENTRAL INDEX KEY: 0001367859
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 205120010
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2174 EASTRIDGE CENTER
CITY: EAU CLAIRE
STATE: WI
ZIP: 54701
BUSINESS PHONE: 715 836 9994
MAIL ADDRESS:
STREET 1: 2174 EASTRIDGE CENTER
CITY: EAU CLAIRE
STATE: WI
ZIP: 54701
4
1
wf-form4_167450867989955.xml
FORM 4
X0306
4
2023-01-19
0
0001367859
Citizens Community Bancorp Inc.
CZWI
0001204872
BROUCEK JAMES S
C/O CITIZENS COMMUNITY BANCORP, INC.
2174 EASTRIDGE CENTER
EAU CLAIRE
WI
54701
0
1
0
0
EVP/CFO/Treasurer/Secretary
Common Stock, par value $0.01 per share
2023-01-19
4
A
0
3169
12.36
A
16604
D
Common Stock, par value $0.01 per share
2023-01-19
4
A
0
2839
12.36
A
19443
D
Common Stock, par value $0.01 per share
40924
I
By IRA
Common Stock Option (right to buy)
13.6
2027-10-31
Common Stock
8000.0
8000
D
Shares earned upon vesting and settlement of Performance Restricted Stock Units ("Performance RSU's") awarded January 23, 2020, upon certification of performance results by the Compensation Committee based on the achievement of certain operational performance criteria for the year ended December 31, 2022, during a 36 month cumulative performance cycle.
Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest equally over three years on each of January 19, 2024, January 19, 2025 and January 19, 2026.
These shares are held in the reporting person's self-directed IRA.
The common stock option awarded under the Company's 2008 Equity Incentive Plan vests as follows: 20% of the shares vest on each of October 31, 2018, October 31, 2019, October 31, 2020, October 31, 2021 and October 31, 2022.
/s/ Rebecca L. Johnson, Attorney-in-fact
2023-01-23