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